Prognostic Role of Neutrophil, Monocyte and Platelet to Lymphocyte Ratios in Advanced Ovarian Cancer According to the Time of Debulking Surgery.

Despite a multimodal radical treatment, mortality of advanced epithelial ovarian cancer (AEOC) remains high. Host-related factors, such as systemic inflammatory response and its interplay with the immune system, remain underexplored. We hypothesized that the prognostic impact of this response could vary between patients undergoing primary debulking surgery (PDS) and those undergoing interval debulking surgery (IDS). Therefore, we evaluated the outcomes of two surgical groups of newly diagnosed AEOC patients according to the neutrophil, monocyte and platelet to lymphocyte ratios (NLR, MLR, PLR), taking median ratio values as cutoffs. In the PDS group (n = 61), low NLR and PLR subgroups showed significantly better overall survival (not reached (NR) vs. 72.7 months, 95% confidence interval [CI]: 40.9-95.2, p = 0.019; and NR vs. 56.1 months, 95% CI: 40.9-95.2, p = 0.004, respectively) than those with high values. Similar results were observed in progression free survival. NLR and PLR-high values resulted in negative prognostic factors, adjusting for residual disease, BRCA1/2 status and stage (HR 2.48, 95% CI: 1.03-5.99, p = 0.043, and HR 2.91, 95% CI: 1.11-7.64, p = 0.03, respectively). In the IDS group (n = 85), ratios were not significant prognostic factors. We conclude that NLR and PLR may have prognostic value in the PDS setting, but none in IDS, suggesting that time of surgery can modulate the prognostic impact of baseline complete blood count (CBC).

Verifying the biocontrol activity of novel film-forming formulations of Candida sake CPA-1: resilience in relation to environmental factors, rainfall episodes, and control of Botrytis cinerea on different hosts.

BACKGROUND: The efficacy of Candida sake CPA-1 as a biocontrol agent against several diseases has been studied since it was isolated 20 years ago. However, it was only recently that two suitable and effective film-forming formulations based on potato starch and maltodextrins were developed using the fluidized-bed spray-drying system. The present work aimed to confirm the capability of both novel formulations by testing their resilience on grapes at different temperatures (0, 22, and 30 °C), relative humidities (40% and 85%), and simulated rainfall levels. Another objective was to examine the control of Botrytis cinerea in different hosts. RESULTS: The CPA-1 cells from both dried formulations survived better than the liquid formulation on grapes stored at 0 and 22 °C regardless of the relative humidity. After simulated rainfall, potato starch formulation achieved significantly higher populations than maltodextrin formulation, although the highest reduction was -1.6 log N N0 -1 . A positive effect of cell establishment prior to the simulated rainfall was shown, and recovered cells from the potato starch formulation were significantly higher after 72 h of cell establishment. Finally, both formulations reduced the incidence and severity of B. cinerea on pears, apples, and tomatoes. CONCLUSION: The potential of these novel film-forming formulations of C. sake CPA-1 was verified. The resilience of formulated C. sake was better than the commercialized liquid formulation, the adherence of the formulations to the grapes improved after an establishment period prior to rain exposure, and the control of B. cinerea was verified in a wider range of hosts. © 2019 Society of Chemical Industry.

Fluidised-bed spray-drying formulations of Candida sake CPA-1 by adding biodegradable coatings to enhance their survival under stress conditions.

The biocontrol agent Candida sake CPA-1 has demonstrated to be effective against several diseases on fruit. However, for application of CPA-1 under field conditions, it was necessary to mix it with a food coating to improve survival under stress conditions, as well as adherence and distribution on fruit surfaces. The objective of this study was to obtain a more competitive formulation under field conditions to be applied independently of any product. To achieve this purpose, the drying process of CPA-1 by a fluidised-bed spray-drying system together with biodegradable coatings was optimised. This approach is novel for the drying system used and the formulation obtained which was able to form a film or coating on fruit surfaces. Several substances were tested as carriers and binders, and drying temperature was optimised. The addition of protective compounds was also tested to improve survival of CPA-1 during the dehydration process. Product shelf life, biocontrol efficacy on grapes against Botrytis cinerea, and the improvement of C. sake behaviour under stress conditions were tested. The optimal temperature of drying was 55 °C and two formulations that were able to develop a coating on fruit surfaces were obtained. One of the formulations was created by using a combination of native and pregelatinised potato starch; the other formulation was obtained using maltodextrin and by adding skimmed milk and sucrose as protectant compounds. The formulated products reduced the incidence and severity of B. cinerea, and CPA-1 survival rate was increased under stress conditions of temperature and humidity.

Dry formulations of the biocontrol agent Candida sake CPA-1 using fluidised bed drying to control the main postharvest diseases on fruits.

BACKGROUND: The biocontrol agent Candida sake CPA-1 is effective against several diseases. Consequently, the optimisation of a dry formulation of C. sake to improve its shelf life and manipulability is essential for increasing its potential with respect to future commercial applications. The present study aimed to optimise the conditions for making a dry formulation of C. sake using a fluidised bed drying system and then to determine the shelf life of the optimised formulation and its efficacy against Penicillium expansum on apples. RESULTS: The optimal conditions for the drying process were found to be 40 °C for 45 min and the use of potato starch as the carrier significantly enhanced the viability. However, none of the protective compounds tested increased the viability of the dried cells. A temperature of 25 °C for 10 min in phosphate buffer was considered as the optimum condition to recover the dried formulations. The dried formulations should be stored at 4 °C and air-packaged; moreover, shelf life assays indicated good results after 12 months of storage. The formulated products maintained their biocontrol efficacy. CONCLUSION: A fluidised bed drying system is a suitable process for dehydrating C. sake cells; moreover, the C. sake formulation is easy to pack, store and transport, and is a cost-effective process. © 2017 Society of Chemical Industry.

Risk of endometrial cancer after RRSO in BRCA 1/2 carriers: a multicentre cohort study.

OBJECTIVE: To know the risk of endometrial cancer (EC) in a population of women with BRCA 1/2 pathogenic or likely pathogenic variants after risk-reducing salpingo-oophorectomy (RRSO). METHODS: The study cohort included data from 857 women with BRCA mutations who underwent RRSO visited four hospitals in Catalonia, Spain, from January 1, 1999 to April 30, 2019. Standardized incidence ratio (SIR) of EC was calculated in these patients using data from a regional population-based cancer registry. RESULTS: After RRSO, eight cases of EC were identified. Four in BRCA 1 carriers and four in BRCA2 carriers. The expected number of cases of EC was 3.67 cases, with a SIR of 2.18 and a 95% CI (0.93-3.95). CONCLUSIONS: In our cohort, the risk of EC in BRCA1/2 carriers after RRSO is not greater than expected. Hysterectomy is not routinely recommended for these patients.

[Trends in child and adolescent mental health in Catalonia in the context of the covid-19 pandemic during the 2020-2021 school year]. / Evolución de la salud mental infanto-juvenil en Catalunya en el contexto de la pandemia por la COVID-19 durante el curso escolar 2020-2021.

Introduction: The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of our study was to assess child and adolescent mental health in a cohort throughout the 2020-2021 school year. Methods: We conducted a longitudinal prospective study in a cohort of children aged 5 to 14 years in Catalonia, Spain, from September 2020 to July 2021. Participants were randomly selected and followed up by their primary care paediatricians. The risk of mental health problems was assessed with the Strengths and Difficulties Questionnaire (SDQ), completed by one of the legal guardians of the child. In addition, we obtained information on the sociodemographic and health characteristics of the participants and their nuclear families. We collected the data by means of an online survey through the REDCap platform at the beginning of the academic year and at the end of each term (4 time points). Results: At the beginning of the school year, 9.8% of participants were cases of probable psychopathology compared to 6.2% at the end of the year. The perceived level of worry of the children for their own health and the health of their families was associated with the presence of psychopathology, especially at the beginning of the year, while the perception of a good family atmosphere was consistently associated with a decreased risk. No variable related to COVID-19 was associated with abnormal results in the SDQ. Conclusions: During the 2020-2021 school year, the percentage of children with probable psychopathology decreased from 9.8% to 6.2%.

Trends in child and adolescent mental health in Catalonia in the context of the COVID-19 pandemic during the 2020-2021 school year.

INTRODUCTION: The SARS-CoV-2 pandemic has had a great impact on the physical and psychological health of the population. The aim of this study was to evaluate child and adolescent mental health in a population cohort along the 2020-2021 school year. METHODS: This was a prospective longitudinal study of a cohort of children from 5-14 years of age in Catalonia, Spain, performed from September 2020 to July 2021. The participants were randomly selected and accompanied by their primary care paediatrician. Evaluation of risk of psychopathology was performed using the Strengths and Difficulties Questionnaire (SDQ) carried out by one of the legal guardians of the child. We also collected sociodemographic and health variables of the participants and their nuclear family. Data were collected by an online survey through the RedCap platform at the beginning of the academic year and at the end of each trimester (4 cuts). RESULTS: At the beginning of the school year, 9.8% of the patients were probable cases of psychopathology compared to 6.2% at the end of the year. The perception of the level of preoccupation of the children for their health and that of their family was related to presenting psychopathology, especially at the beginning of the year, with the perception of a good family atmosphere being always related to lower risk. No variable related to COVID-19 was associated with an altered SDQ result. CONCLUSIONS: Along the 2020-2021 school year, the percentage of children with a probability of presenting psychopathology decreased from 9.8% to 6.2%.

Psychotropic use in children and adolescents in Scandinavia and Catalonia: a 10-year population-based study.

RATIONALE: The use of psychotropic drugs in the paediatric population has not been the subject of many studies, due to the fact that this population is generally not included in clinical trials and these drugs are not authorized for use on minors. OBJECTIVES: This study aims to provide an accurate description of psychotropic drug use in children and adolescents in the North of Europe and Catalonia. METHODS: Data from 2008 to 2017 on psychotropic drug consumption in children and adolescents were retrieved from the databases of Catalonia, Denmark, Norway and Sweden. Psychotropic drugs were divided into antipsychotics, anxiolytics (also hypnotics and sedatives), antidepressants and psychostimulants. Data were stratified by group of age (0-4, 5-9, 10-14 and 15-19/15-17 for Denmark and Catalonia) and sex. RESULTS: Overall, the group of anxiolytics shows the highest consumption and the group of antipsychotics the lowest. In 2017, Sweden was the country with the highest consumption of psychotropic drugs (6.67‰) and has the highest increase in consumption (152.8%), and Denmark has the lowest consumption for all groups (3.13‰). Catalonia shows a decrease in psychotropic drugs (-15.9%). Girls consume more than twice as many antidepressants as boys while the opposite is true for psychostimulants. Risperidone and quetiapine are among the most consumed antipsychotics in the Nordic countries, whereas in Catalonia they are risperidone and aripiprazole. Among antidepressants, sertraline is the most consumed. No differences are found among the psychostimulants. CONCLUSIONS: Psychotropic consumption in younger populations is increasing, although there are differences between the countries as far as which drugs are used. Nordic countries show a higher prevalence of use than Catalonia. Psychotropic drug consumption increases with age, except for psychostimulants, which have the highest utilization rate among 10-14-year-olds.

State of child and adolescent mental health during the first wave of the COVID-19 pandemic and at the beginning of the 2020-2021 school year.

INTRODUCTION: The aim of this project was to evaluate the psychopathological impact of home confinement and school closing between March and September 2020 on the mental health of Catalonian children. METHODS: PEDSAME study: first cross-sectional section (beginning of the school year) and retrospective data (lockdown), carried out through the network of Primary Care pediatricians in the Catalan population between 5 and 14 years (included) from 09/14/2020 to 10/30/2020 in a random sample. Data were collected with an online survey through the RedCap platform at the beginning of the school year. The main variable was the result of the Strengths and Difficulties Questionnaire answered by parents to assess the risk of psychopathology, in addition to other related variable. RESULTS: The results obtained at the beginning of the school year show that 9.8% of the patients were probable cases of psychopathology. The most affected group were those between 5 and 8 years. The perception of the children's level of concern for their health and that of their family was a risk factor for presenting psychopathology, while the good family environment was a protective factor. Emotional and behavioral symptoms, sleep disorders and problematic use of screens were detected more frequently during confinement than at the beginning of the school year. CONCLUSIONS: Confinement and the absence of schooling for 6 months had a negative impact on the mental health of the child-adolescent population who showed worse indicators than the previous year.

[State of child and adolescent mental health during the first wave of the COVID-19 pandemic and at the beginning of the 2020-2021 school year]. / Estado de la salud mental infantojuvenil durante la primera ola de la pandemia de la COVID-19 y en el inicio del curso escolar 2020-2021.

INTRODUCTION: The aim of this project was to evaluate the psychopathological impact of home confinement and school closing between March and September 2020 on the mental health of Catalonian children. METHODS: PEDSAME study: first cross-sectional section (beginning of the school year) and retrospective data (lockdown), carried out through the network of Primary Care pediatricians in the Catalan population between 5 and 14 years (included) from 09/14/2020 to 10/30/2020 in a random sample. Data were collected with an online survey through the RedCap platform at the beginning of the school year. The main variable was the result of the Strengths and Difficulties Questionnaire answered by parents to assess the risk of psychopathology, in addition to other related variable. RESULTS: The results obtained at the beginning of the school year show that 9.8% of the patients were probable cases of psychopathology. The most affected group were those between 5 and 8 years. The perception of the children's level of concern for their health and that of their family was a risk factor for presenting psychopathology, while the good family environment was a protective factor. Emotional and behavioral symptoms, sleep disorders and problematic use of screens were detected more frequently during confinement than at the beginning of the school year. CONCLUSIONS: Confinement and the absence of schooling for 6 months had a negative impact on the mental health of the child-adolescent population who showed worse indicators than the previous year.

Specialist palliative and end-of-life care for patients with cancer and SARS-CoV-2 infection: a European perspective.

BACKGROUND: Specialist palliative care team (SPCT) involvement has been shown to improve symptom control and end-of-life care for patients with cancer, but little is known as to how these have been impacted by the COVID-19 pandemic. Here, we report SPCT involvement during the first wave of the pandemic and compare outcomes for patients with cancer who received and did not receive SPCT input from multiple European cancer centres. METHODS: From the OnCovid repository (N = 1318), we analysed cancer patients aged ⩾18 diagnosed with COVID-19 between 26 February and 22 June 2020 who had complete specialist palliative care team data (SPCT+ referred; SPCT- not referred). RESULTS: Of 555 eligible patients, 317 were male (57.1%), with a median age of 70 years (IQR 20). At COVID-19 diagnosis, 44.7% were on anti-cancer therapy and 53.3% had ⩾1 co-morbidity. Two hundred and six patients received SPCT input for symptom control (80.1%), psychological support (54.4%) and/or advance care planning (51%). SPCT+ patients had more 'Do not attempt cardio-pulmonary resuscitation' orders completed prior to (12.6% versus 3.7%) and during admission (50% versus 22.1%, p < 0.001), with more SPCT+ patients deemed suitable for treatment escalation (50% versus 22.1%, p < 0.001). SPCT involvement was associated with higher discharge rates from hospital for end-of-life care (9.7% versus 0%, p < 0.001). End-of-life anticipatory prescribing was higher in SPCT+ patients, with opioids (96.3% versus 47.1%) and benzodiazepines (82.9% versus 41.2%) being used frequently for symptom control. CONCLUSION: SPCT referral facilitated symptom control, emergency care and discharge planning, as well as high rates of referral for psychological support than previously reported. Our study highlighted the critical need of SPCTs for patients with cancer during the pandemic and should inform service planning for this population.

Clinical portrait of the SARS-CoV-2 epidemic in European cancer patients.

The SARS-Cov-2 pandemic significantly impacted on oncology practice across the globe. There is uncertainty as to the contribution of patients' demographics and oncological features on severity and mortality from Covid-19 and little guidance as to the role of anti-cancer and anti-Covid-19 therapy in this population. In a multi-center study of 890 cancer patients with confirmed Covid-19 we demonstrated a worsening gradient of mortality from breast cancer to haematological malignancies and showed that male gender, older age, and number of co-morbidities identifies a subset of patients with significantly worse mortality rates from Covid-19. Provision of chemotherapy, targeted therapy and immunotherapy did not worsen mortality. Exposure to antimalarials was associated with improved mortality rates independent of baseline prognostic factors. This study highlights the clinical utility of demographic factors for individualized risk-stratification of patients and support further research into emerging anti-Covid-19 therapeutics in SARS-Cov-2 infected cancer patients.

Presenting Features and Early Mortality from SARS-CoV-2 Infection in Cancer Patients during the Initial Stage of the COVID-19 Pandemic in Europe.

We describe the outcomes in cancer patients during the initial outbreak of the COVID-19 in Europe from the retrospective, multi-center observational OnCovid study. We identified 204 cancer patients from eight centers in the United Kingdom, Italy, and Spain aged > 18 (mean = 69) and diagnosed with COVID-19 between February 26th and April 1st, 2020. A total of 127 (62%) were male, 184 (91%) had a diagnosis of solid malignancy, and 103 (51%) had non-metastatic disease. A total of 161 (79%) had > 1 co-morbidity. A total of 141 (69%) patients had > 1 COVID-19 complication. A total of 36 (19%) were escalated to high-dependency or intensive care. A total of 59 (29%) died, 53 (26%) were discharged, and 92 (45%) were in-hospital survivors. Mortality was higher in patients aged > 65 (36% versus 16%), in those with > 2 co-morbidities (40% versus 18%) and developing > 1 complication from COVID-19 (38% versus 4%, p = 0.004). Multi-variable analyses confirmed age > 65 and > 2 co-morbidities to predict for patient mortality independent of tumor stage, active malignancy, or anticancer therapy. During the early outbreak of SARS-CoV-2 infection in Europe co-morbid burden and advancing age predicted for adverse disease course in cancer patients. The ongoing OnCovid study will allow us to compare risks and outcomes in cancer patients between the initial and later stages of the COVID-19 pandemic.

Novel film-forming formulations of the biocontrol agent Candida sake CPA-1: biocontrol efficacy and performance at field conditions in organic wine grapes.

BACKGROUND: The biocontrol agent (BCA) Candida sake CPA-1 has previously effectively reduced Botrytis bunch rot (BBR) and it was also suggested as a promising strategy to control sour rot in grapes under field conditions. However, biocontrol efficacy of solid formulations of CPA-1 has never been tested in field trials. The present study aims to confirm the efficacy against BBR and sour rot in grapes under field conditions of two novel formulations recently developed by the addition of biodegradable coatings using a fluidized-bed spray-drying system. RESULTS: Novel film-forming formulations of the BCA C. sake CPA-1 controlled B. cinerea as well as liquid formulation. Sour rot control resulted better in the second season and severity reductions were more satisfactory than incidence control. Visual and cryoSEM observations revealed that film-forming treatments were uniformly distributed on plant surfaces. CPA-1 coating could be observed on grapes at harvest time. CONCLUSION: The results of this work suggest that solid formulations would be a competitive alternative to conventional fungicides because they were easy to package and transport, and cell viability could be maintained for a long period of time. © 2018 Society of Chemical Industry.