The role of area deprivation index in health care disruptions among cancer survivors during the SARS-CoV-2 pandemic.

OBJECTIVE: To examine the associations between demographic/medical and geographic factors with follow-up medical care and health-related quality of life (HRQoL) among cancer survivors during the SARS-CoV-2 pandemic. STUDY DESIGN: Cross-sectional survey. METHODS: An online survey was sent to cancer survivors between May 2020 and January 2021, exploring their experience with SARS-CoV-2, follow-up care, and HRQoL. PolicyMap was used to geocode home addresses. Both geographic and demographic/medical factors were examined for their associations with SARS-CoV-2 experience, follow-up care, and HRQoL (FACT-G7). RESULTS: Geographic data were available for 9651 participants. Patients living in the highest area deprivation index (ADI) neighborhoods (most deprived) had higher odds of avoiding in-person general (odds ratio [OR] = 7.20; 95% confidence interval [CI] = 2.79-18.60), cancer (OR = 8.47; 95% CI = 3.73-19.30), and emergency (OR = 14.2; 95% CI = 5.57-36.30) medical care, as well as lower odds of using telemedicine (OR = 0.61; 95% CI = 0.52-0.73) compared to the lowest ADI group. Race/ethnicity was not associated with follow-up care after controlling for ADI. The effect of ADI on HRQoL was generally in the expected direction, with higher ADI being associated with worse HRQoL. CONCLUSIONS: ADI influenced follow-up medical care more than age, race/ethnicity, or health insurance type. Healthcare providers and institutions should focus on decreasing barriers to in-person and telemedicine health care that disproportionally impact those living in more deprived communities, which are exacerbated by health care disruptions like those caused by the SARS-CoV-2 pandemic.

Exploratory Study of Low Resolution Electromagnetic Tomography (LORETA) Real-Time Z-Score Feedback in the Treatment of Pain in Patients with Head and Neck Cancer.

Acute pain from mucositis in patients with head and neck cancer (HNC) undergoing radiation therapy (RT) is common, and may not respond well to narcotics. We used low resolution electromagnetic tomography z-score neurofeedback (LFBz) to investigate whether patients could modify brain wave activity associated with acute pain and whether this would reduce the experience of pain. HNC patients scheduled for RT had baseline pre-pain onset measures (EEG and numeric rating scale) collected before RT and then at pain onset before using analgesics, after each LFBz session and at the end of RT. Up to six sessions of LFBz training were offered over the remaining RT. Up to six 20-min sessions of LFBz were offered over the remaining RT. Data were collected before and after each LFBz session and at the end of RT. Seventeen patients recruited; fourteen were treated and reported decreased pain perception. LFBz allowed patients to modify their brain activity in predesignated areas of the pain matrix toward the direction of their baseline, pre-pain condition (including Brodmann areas (BAs) 3, 4, 5, 13, 24, and 33). LFBz can modify brain regions relevant for pain and these changes were associated with self-reported decreases in pain perception.

Effect of fatty acids on estradiol and testosterone binding to whole DU-145 prostate cells.

Cancer of the prostate is one of the leading causes of cancer related deaths in men. An important role in the development of prostate cancer is played by androgens and androgen ablation is therefore currently used in cancer treatment. In the past, estrogens were widely used in treatment of prostate cancer, but there are indications that estrogens could also be involved in carcinogenesis. Lately, much research has been done on the modulation of the binding of steroid hormones to their receptors by polyunsaturated fatty acids (PUFAs), which could interfere with the steroid hormone's message. Therefore, the aim of this study was to determine in whole DU-145 human prostate cells the effect of EFAs and their metabolites on the binding and affinity of the estrogen receptor (ER) and androgen receptor (AR) to estradiol (E(2)) and testosterone (T), respectively. Fatty acids were dissolved in ethanol and added to the cell culture in a final ethanol concentration of 0.2% on the fourth day of incubation. The results showed that the PUFAs under investigation inhibited the AR's capacity, in contrast to the ER's capacity which was stimulated. However, the dissociation constants (K(d)) of the AR and ER complexes in the presence of the PUFAs, were as follows. Except for eicosapentaenoic acid (EPA) which decreased the AR dissociation constant and EPA and alpha-linolenic acid (ALA) which increased the ER dissociation constant, the remaining FAs had no significant effect on the K(d) values of both the AR and ER complexes. According to these priliminary results it is postulated that men should benefit with a diet rich in certain essential polyunsaturated fatty acids although its function remains to be clarified.

Cytotoxicity of combined essential fatty acids on a human prostate cancer cell line.

In this study the effect of single and concomitantly added n-6 or n-3 polyunsaturated fatty acids (PUFAs) was investigated on human prostate cells. Data obtained from the single fatty acids (FAs) experiments showed that except for oleic acid (OA), arachidonic (AA) and linoleic acid (LA), which had very little (less than 10% cells dead) effect on the cells, an increase in dead cells was observed at physiological concentrations of, eicosapentaenoic acid (EPA), gamma-linolenic acid (GLA) and alpha-linolenic acid (ALA). However, this was not the case when combining these acids at physiological concentrations. A slight increase in cell death was only obtained with three combinations of ALA, namely with AA, OA, or GLA. Other combinations with ALA, such as with LA or EPA, had respectively no effect on cell number or increased the cell number by causing less cells to die. Other PUFAs combinations tested, did not show the three groups mentioned with ALA, but only the last two types, namely, no effect, or a decrease in the amount of cell death. The latter might mean that the FA combination had stimulated the cells, since a decrease in the amount of dead cells was observed. Therefore, it is concluded that the characteristics of combined FAs may differ from single FAs, which may explain some controversies in the literature and in response to treatments.

Influence of industrialization on an African urban community.

There is a steady trend towards urbanization in all countries, especially in developing countries. This leads to concentration of medical care, adding to road traffic congestion. In one hospital in South Africa the number of patients X-rayed increased significantly, from 80,402 in 1977 to 96,251 in 1980. 62% of all the patients were from casualty or outpatient clinics. Only 20% of the ambulatory patients were admitted. About 50% of all patients X-rayed were, therefore, not hospitalized. Most of them required relatively simple X-ray examinations, whereas inpatients needed more complex procedures. Building bigger hospitals and X-ray departments may not be the correct solution. Decentralized and cheaper facilities may be better and would also decrease the load on the larger and more complex X-ray departments.

Gas chromatographic relative retention data for pesticides on nine packed columns: II. Organophosphorus and organochlorine pesticides, using electron-capture detection.

The retention time relative to parathion, absolute retention time, concentration range, peak asymmetry factor, and peak shape class are given for each of 42 organophosphorus pesticides and 28 organochlorine pesticides analyzed by gas chromatography (GC) on 9 different packed columns. The packing materials used were 3% SP-2100, 1% Dexsil-300, 3% OV-17, 1.5% OV-17 + 1.95% QF-1, 4% SE-30 + 6% QF-1, 3% OV-17 + 3% OV-210, 5% DC-200 + 7.5% QF-1,3% Carbowax-20M, and 4% Reoplex-400. Retention data were determined at 200 degrees C with a carrier gas flow at uopt, using a 63Ni electron-capture detector. Results should be useful for preliminary identification of environmental samples and also for single or multiple pesticide residue analysis.

Suppression of uterine activity with salbutamol before caesarean section.

In 32 patients undergoing emergency intrapartum caesarean section labour was suppressed with 250 micrograms salbutamol. The biochemical status of the neonates was compared with that of 15 controls. The initial results did not demonstrate a major difference between the two groups, but when only proven cases of fetal distress (H less than 7,25) in the two groups were compared, a significant improvement in the PO, pH and base deficit values in the umbilical vein as well as in the PO2 and pH values in the umbilical artery was noted in the group which had been given salbutamol. No major maternal side-effects were noted and this, together with the simplicity of the regimen, makes it a valuable temporizing measure in such cases.

The effectiveness of salbutamol as a suppressant of established labour.

The effectiveness of beta 2-adrenergic stimulants as suppressants of active labour is well known. This study examines the effects of salbutamol upon established labour in 32 patients undergoing emergency caesarean section. Twenty-five (78,1%) of the patients studied showed a sustained and effective suppression of labour after a bolus intravenous injection of 250 micrograms salbutamol. In 6 of the 7 remaining patients the parameters of uterine activity were also dramatically decreased, but because uterine activity recurred, it had to be further suppressed with an intravenous infusion. There was only 1 refractory case. No serious maternal or fetal side-effects were noted, and patient acceptance was good.

Oral susceptibility of South African Culicoides species to live-attenuated serotype-specific vaccine strains of African horse sickness virus (AHSV).

The oral susceptibility of livestock-associated South African Culicoides midges (Diptera: Ceratopogonidae) to infection with the tissue culture-attenuated vaccine strains of African horse sickness virus (AHSV) currently in use is reported. Field-collected Culicoides were fed on horse blood-virus mixtures each containing one of the seven serotype-specific vaccine strains of AHSV, namely serotypes 1, 2, 3, 4, 6, 7 and 8. The mean titres of virus in the bloodmeals for the seven vaccine strains were between 6.8 and 7.6 log10TCID50/mL. All females (n = 3262) that survived 10 days extrinsic incubation (10 dEI) at 23.5 degrees C were individually assayed in microplate BHK-21 cell cultures. In midges tested immediately after feeding, AHSV was detected in 96.1% individuals; mean virus titre was 2.0 log10TCID50/midge. After 10 dEI virus recovery rates varied in Culicoides (Avaritia) imicola Kieffer from 1% (AHSV-2) to 11% (AHSV-7) and in Culicoides (A.) bolitinos Meiswinkel from 0% (AHSV-3) to 14.6% (AHSV-2). Although our results indicate that two major field vectors C. imicola and C. bolitinos are susceptible to oral infection with vaccine strains of AHSV, the level of viral replication for most of the vaccine strains tested was below the postulated threshold (=2.5 log10TCID50/midge) for fully disseminated orbivirus infection. In this study, for the first time AHSV has been recovered after 10 dEI from six non-Avaritia livestock-associated Old World species: C. engubandei de Meillon (AHSV-4), C. magnus Colaço (AHSV-3, -4), C. zuluensis de Meillon (AHSV-2, -4), C. pycnostictus Ingram & Macfie (AHSV-2), C. bedfordi Ingram & Macfie (AHSV-7), and C. dutoiti de Meillon (AHSV-7). As little is known about the virogenesis of AHSV in the southern African species of Culicoides, the epidemiological significance of our findings in relation to the potential for transmission of current AHSV vaccine strains by Culicoides requires further assessment.

Computed axial tomography of the body with the EMI general purpose scanner. A preliminary assessment.

Computed axial tomography (CAT) of the brain has already proved itself to be the first line in the diagnosis of intracranial lesions. With the installation of the EMI (CT 5005) general purpose scanner at Garden City Clinic in mid-October 1977, we have been utilizing this technique not only on the cranium but on the rest of the body as well. It has proved an invaluable diagnostic tool, in that the diagnosis can often be made with this technique alone. It short-circuits many of the sophisticated routine X-ray studies which require hospitalization, an anaesthetic, and time lost to the patient and doctor. In many cases it has obviated the need for an exploratory laparotomy. In most cases the technique can be performed on outpatients; the patient is perfectly relaxed during the scan, and may be saved days in hospital. There are limitations, however, and patients should be carefully selected. A discussion of the indications for body scanning in both our own and overseas experience therefore seems in order.