Post-Coronavirus Disease 2019 (COVID-19) Syndrome Associated with Central Retinal Vein Occlusion: A Case Report.

PURPOSE: Coronavirus Disease 2019 (COVID-19) pneumonia may predispose to thromboembolic disease, including after the acute phase. We report on a unique case of central retinal vein occlusion (CRVO) occurring eight months after diagnosis of Coronavirus Disease 2019 (COVID-19) pneumonia in a likely case of post-COVID-19 syndrome. CASE REPORT: A 42-year-old man developed blurred vision in his right eye eight months after symptoms of pneumonia. He had no underlying medical conditions, but experienced exertional chest pain since diagnosis of COVID-19 was confirmed by detection of SARS-CoV-2 on nasopharyngeal swab and was also seeing cardiology for management of myocarditis. His best-corrected visual acuity on snellen chart testing was reduced to 6/18 in the affected right eye, and dilated fundal examination revealed a non-ischaemic CRVO. CONCLUSION: The thromboembolic complications of COVID-19 may extend to CRVO, which in this case presented months after onset of symptoms of pneumonia, in association with myocarditis.

Evaluation of Pupillometric Parameters in Patients with COVID-19.

PURPOSE: To investigate the pupillary diameter and pupillary light response in patients who have recovered from the COVID-19. METHODS: Thirty two eyes of 32 patients with a history of COVID-19 in the last two months and 32 eyes of 32 age and sex-matched healthy controls were included in this prospective study. All patients had neurological symptoms. Dynamic and static pupillometry measurements were performed with the Sirius (CSO, Italy) corneal topography device. RESULTS: Patients with COVID-19 had higher mean scotopic, mesopic, and photopic pupil diameters compared to the controls (p = .01, p = .04, p = .02, respectively). In dynamic pupillometry analysis, 0th, 2th, 8th and 16th second pupil diameter measurements were higher in COVID-19 patients (p = .02, p = .04, p = .04, p = .04, respectively). There were no differences in the average speed of pupillary dilatation (p > .05). CONCLUSION: Our findings suggest that the pupillary response, an indicator of autonomic nervous system activity, may be affected in COVID-19 patients with neurological symptoms.

Structure of Adverse Events Following Immunisation against Coronavirus Infection (COVID-19) in the Kyrgyz Republic

There is considerable interest worldwide in developing safe and effective vaccines against COVID-19. Pharmacovigilance of adverse events following immunisation (AEFIs) is a key to making informed decisions regarding the global COVID-19 vaccination campaign. In the Kyrgyz Republic, there have been developed a national immunisation information system (IIS) for automated recording of vaccines, vaccinated persons, and AEFIs and a mobile application for AEFI reporting, called Den Sooluk. The aim of the study was to analyse the pattern of AEFIs against COVID-19 in the Kyrgyz Republic. Materials and methods: the study analysed the spontaneous safety reports submitted to the national IIS database through the Den Sooluk mobile application from 29.03.2021 to 25.09.2022. Results: according to the data available by 25.09.2022, the total number of vaccinated people in the country amounted to 2,940,082. At the time, the IIS database included 2111 AEFIs: 1 fatal (and coincidental), 3 severe and 2108 minor ones. AEFIs were more frequent in the young and middle-aged population (81.5%), than in the elderly (18.5%). The following AEFIs were reported: injection site pain (21.25%), fatigue (20.7%), headache (19.8%), body temperature above 38 ºC (10.10%), miscellaneous symptoms (5.12%), chills (4.41%), dizziness (4.32%), sore throat (3.36%), myalgia (2.9%), and nausea (2.2%). Conclusions: all COVID-19 vaccines used in the Kyrgyz Republic can be considered adequately safe. Pharmacovigilance of AEFIs is an integral part of the requirements to ensure the safe use of vaccines, and collecting of spontaneous reports on AEFIs supports adequate functioning of the post-marketing surveillance system. It is essential to provide access to electronic information platforms to health professionals and patients in order to ensure vaccination transparency and coordination and enable quick and safe reporting of AEFIs associated with the use of COVID-19 vaccines.

The study of the quality control of clinical research related to the prevention and treatment by traditional Chinese medicine

The scientific research on prevention and control of coronavirus disease 2019 (COVID-19) has been a major and urgent task, of which clinical trials occupy a pivotal position in the entire prevention and control system. 204 relative clinical trials of traditional Chinese medicine (TCM) have been registered on Chinese Clinical Trial Registry. Through the analysis of all online public protocols of registered trials, it is found that the clinical studies of TCM in China showed lack of research foundation, tight time and heavy tasks, difficult clinical implementation, and disturbance by changes of the epidemic status. Based on these characteristics, this paper put forward several thoughts and suggestions on the quality management and design improvement for clinical trials of TCM preventing and treating COVID-19, in order to improve the quality of clinical trials in China, provide effective supports for the public health decision-making on the epidemic, and also give a reference for the prevention and control of epidemics in the future. © 2023 West China University of Medical Science. All rights reserved.

Acupuncture for olfactory dysfunction in infected COVID-19 patients: Study protocol for a randomized, sham-controlled clinical trial

Background: Olfactory dysfunction (OD) is a common symptom of Corona Virus Disease 2019 (COVID-19). It is defined as the reduced or distorted ability to smell during sniffing (orthonasal olfaction) and represents one of the early symptoms in the clinical course of COVID-19 infection. A large online questionnaire-based survey has shown that some post-COVID-19 patients had no improvement 1 month after discharge from the hospital. Objective: To explore the efficacy of acupuncture for OD in COVID-19 infected patients and to determine whether acupuncture could have benefits over sham acupuncture for OD in post-COVID-19 patients. Methods: This is a single-blind, randomized controlled, cross-over trial. We plan to recruit 40 post-COVID-19 patients with smell loss or smell distortions lasting for more than 1 month. Qualified patients will be randomly allocated to the intervention group (real acupuncture) or the control group (sham acupuncture) at a 1:1 ratio. Each patient will receive 8 sessions of treatment over 4 weeks (Cycle 1) and a 2-week follow-up. After the follow-up, the control group will be subjected to real acupuncture for another 4 weeks (Cycle 2), and the real acupuncture group will undergo the 4-week sham acupuncture. The primary outcomes will be the score changes on the questionnaire of olfactory functioning and olfaction-related quality of life at week 6, 8, 12, and 14 from the baseline. The secondary outcomes will be the changes in the olfactory test score at week 6 and 12 from the baseline measured by using the Traditional Chinese version of the University of Pennsylvania Smell Identification Test (UPSIT-TC). Discussion: The results of this trial will help to determine the effectiveness of acupuncture for OD in post-COVID-19 patients. This may provide a new treatment option for patients.

The problem of anti-vaccine attitudes in the COVID-19 era: analysis in the context of psychopathological dimensions and treatment proposals based on own experience

Anti-vaccine attitudes against COVID-19 are a common phenomenon, but rarely understood as a medical problem. In patients who are already under psychiatric treatment, it is worth paying attention to diagnosis and starting of psychotherapy of this problem. The association of the anti-vaccine issue with anxiety, obsession and paranoia is an opportunity to achieve solution and may lead to the progress of psychotherapy. The problem with the right choice of authority seems to be one of most important challenges for psychiatry these days.

Antimicrobial Therapy and COVID-19 - the 'Great Confrontation'

The problem of antimicrobial therapy (AMT) for the new coronavirus infection has been the cornerstone of practical healthcare since its emergence to the present day. The article summarizes a number of problems concerning the unjustified prescription of AMT based on the data of foreign and domestic studies, as well as actual clinical practice. On the one hand, viral damage to the lung tissue during COVID-19 is difficult to distinguish from community-acquired or secondary bacterial pneumonia;it prompts clinicians to prevent possible bacterial complications in the lungs by prescribing broad-spectrum antibiotics starting from the first day. On the other hand, the presence of clear clinical and biological markers of bacterial pneumonia;and COVID-19 makes it possible not to use antibiotics in routine practice, at least in the early stages of treatment. The introduction of procalcitonin as a biomarker of bacterial infection in COVID-19 into everyday clinical practice has a reasonable, methodical, and scientific approach to prescribing antibiotics.

Epidemiology and survival of lung cancer patients, the impact of COVID-19. (clinical and population-based study)

Aim. The study is aimed at investigating the incidence of lung cancer (LC) at the population level with the analysis of key analytical indicators in the context of coronavirus. Materials and methods. We have used data from the IARC, statistical reference books of P.A. Herzen Moscow Research Oncological Institute, data from N.N. Petrov NMRC of Oncol¬ogy, and the database of the Population Cancer Registry of St. Petersburg (DB PCR St. Petersburg) for the current study. Results. The study has established a steady decline in the incidence of LC among the male population in the worldwide, in Russia and in St. Petersburg. Among the female population, a significant increase in the incidence has been revealed. On the basis of the database PCR St. Petersburg, the patterns of age-sex indicators of the incidence of LC have been analyzed. It has been established that the largest number of cases is registered in the age group of patients over 70 years old, here the largest losses due to coronavirus have also been identified. An increase in the proportion of early stages of the disease has been noted. The accounting reliability index decreased from 2000 to 2019, with the exception of 2017. Comparison of yearly lethality in the DB PCR St. Petersburg showed a signifi¬cant difference in the data. The detailed localization structure of LC has been studied, where it has been found out that the first place is occupied by cancer of the upper lobe, bronchi or lung, although over 19 years of observation, a decrease in the proportion of this localization in the total volume of C34 has been noted. The proportion of patients with LC without histological verification has decreased. The influence of the smoking factor on the increased risk of LC has been studied.

Opportunities and challenges of COVID-19 therapy using mesenchymal stem cells and their exosomes

BACKGROUND: Corona Virus Disease 2019 (COVID-19) is a highly contagious, rapidly variable, and dangerous infectious disease. However, no specific and effective treatment for COVID-19 is available until now. The safety and efficacy of mesenchymal stem cells and their exosomes have been well verified in numerous clinical trials. Their immunomodulatory and tissue regeneration capabilities may support them as a prospective therapy for COVID-19 application in the clinic. OBJECTIVE: To focus on the development, pathogenesis and the current treatment status of COVID-19, efficacy and possible immunomodulatory mechanisms of mesenchymal stem cells and their exosomes for COVID-19 so as to provide new insights into the clinical treatment for the disease in the future. METHODS: Articles were searched on PubMed and CNKI with the key words of "SARS-CoV-2, COVID-19, cytokine storm, acute respiratory distress syndrome, mesenchymal stem cells, exosomes, immune regulation, tissue repair” in Chinese and English. Finally, 64 articles were collected for this review. RESULTS AND CONCLUSION: Acute respiratory distress syndrome and acute lung injury caused by cytokine storm are the primary precipitating factors of death in individuals with COVID-19. Mesenchymal stem cells and their exosomes can effectively treat the symptoms of acute respiratory distress syndrome and repair the damaged lung tissue in COVID-19 patients by reducing the cytokine storm and promoting the regeneration of alveolar epithelial cells through the interaction with immune cells and their paracrine effects. All of these investigations confirmed that mesenchymal stem cells and their exosomes can fight the COVID-19 infection, and this might be a promising, safe and effective strategy. However, more preclinical studies and randomized, controlled clinical trials are needed to conduct the biodistribution, metabolic fate, and the potential treatment risks of mesenchymal stem cells and their derived exosomes in vivo to fully exploit their clinical efficacy. © 2023, Publishing House of Chinese Journal of Tissue Engineering Research. All rights reserved.

Meeting report: 6th Global Forum on Tuberculosis Vaccines, 22–25 February 2022, Toulouse, France

Safe, effective, and accessible vaccines are urgently needed to end tuberculosis (TB) by 2030. The 6th Global Forum on TB Vaccines, convened virtually 22–25 February 2022, was hosted by Toulouse, France, under the high patronage of President Emmanuel Macron, and the patronages of Minister for Solidarity and Health, Olivier Véran, and Minister for Higher Education, Research and Innovation, Frédérique Vidal. The theme for the meeting, "New horizons for TB vaccines”, reflected the changing landscape in which TB vaccine research and development (R&D) is being conducted: TB vaccines advancing into late-stage clinical trials and toward licensure, innovative research toward diversifying the TB vaccine pipeline and developing the next generation of candidates, increasing political, civil society, and community support for TB vaccines, and the ongoing COVID-19 pandemic. In this report, we summarize key themes and findings from the meeting, highlighting progress and gaps in the TB vaccine field.

RENIN-ANGIOTENSIN SYSTEM BLOCKER AND THE COVID-19 AGGRAVATION: REPORT BY THE COVID-19 REGISTRY JAPAN

Objective: The role of angiotensin converting enzyme inhibitors (ACEi) and angiotensin II receptor blockers (ARB) in the pandemic context of coronavirus disease 2019 (COVID-19) continues to be debated. Patients with hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or chronic obstructive pulmonary disease (COPD), who often use ACEi/ARB, may affect risk of severe COVID-19. However, there are no data available on the association of ACEi/ARB use with COVID-19 severity in this population. Design and method: This study is an observational study of patients with a positive SARS-CoV-2 test and inpatient treatment at a healthcare facility, using the registry information of COVIREGI-JP. Our primary outcomes were consisting of in-hospital death, ventilator support, extracorporeal membrane oxygenation support, and ICU admission. Out of the 6,055 patients, 1,921 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease, or COPD were enrolled. We also evaluated 1,097 patients with hypertension. Results: Factors associated with an increased risk of the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes mellitus. No correlations were observed with ACEi/ARB, cerebro-cardiovascular diseases, or hypertension. Associated factors in male patients were aging, renal impairment, hypertension, and diabetes. In female patients, factors associated with an increased risk were aging, ACEi/ARB, renal impairment, and diabetes, whereas hypertension was associated with a lower risk of the primary outcomes. In patients with hypertension, factors associated with an increased risk of the primary outcomes were aging, male sex, severe renal impairment, and diabetes mellitus, but not ACEi/ ARB, cerebro-cardiovascular diseases, or COPD. Conclusions: Independent factors for the primary outcomes were aging, male sex, COPD, severe renal impairment, and diabetes, but not ACEi/ARB, in the COVID-19 patients with preexisting hypertension, diabetes mellitus, chronic renal failure, cerebro-cardiovascular disease or COPD. Based on this registry data analysis, more detailed data collection and analysis is needed with the cooperation of multiple healthcare facilities.

POST-VACCINATION SARS-COV-2 IGG ANTIBODY TITER IN DIALYSIS PATIENTS

Background: Dialysis patients have a higher COVID-19 fatality rate than the general population and are priority candidates for SARS-CoV-2 vaccination. However, dialysis patients are immunocompromised, suggesting that they may develop a less immune response to COVID-19 vaccination than healthy individuals. Objective and Methods: A total of 358 hemodialysis patients who were twicevaccinated with BNT162b2 were included. SARS-CoV-2 IgG antibody titer was measured within 7 days to 1 month, 1∼2 months, and 3∼4 months after the second vaccination, and factors influencing antibody titer were statistically investigated. SARS-CoV-2 IgG measurement was performed using SARS-CoV-2 IgG II Quant Reagent (Abbott), which is a reagent to quantitatively measure IgG antibodies against the receptor-binding domain of SARS-CoV-2 spike protein. Results: The patients were 240 males (67%) and 118 females, ranging from 37 to 95 years old, with a median age of 70 years. Causes of kidney failure were diabetes mellitus in 35.2%, hypertensive kidney disease in 7.3%, glomerular disease in 30.5%, and polycystic kidney disease in 4.5% of the patients. Comorbidities were hypertension in 64.3% and diabetes in 48.9%. Steroids or immunosuppressive drugs were used in 9% of the patients. SARS-CoV-2 IgG antibody titers at 7 days to 1 month, 1 to 2 months, and 3 to 4 months (median 10, 42, and 98 days) after the second vaccination have the median of 4092 AU/mL(with interquartile range: 1354, 7592), 2199 (927, 4692), and 789 (323, 1559), respectively. Post-vaccination SARS-CoV-2 IgG titers were significantly correlated with Kt/V, the presence of autoimmune diseases, the use of steroids or immunosuppressive drugs, malignancy treatment, and serum albumin and hemoglobin levels. Multivariate analysis showed that the factors that decreased post-vaccination SARS-CoV-2 IgG titer were the use of steroids and immunosuppressive drugs, the presence of malignant tumors under treatment, and hypoalbuminemia. Conclusion: Compared to healthy subjects in previous reports, dialysis patients had lower SARS-CoV-2 IgG titers after COVID-19 vaccination, suggesting that the vaccine may not be sufficiently effective. In addition, SARS-CoV-2 IgG titers are likely to be even lower in patients at high risk for decreased immune response due to medications or comorbidities. Additional vaccination may be essential for hemodialysis patients who are expected to have low SARS-CoV-2 IgG titers.

Is There any Effect of COVID-19 on Follicular Environment in Women Underwent ART?

There is insufficient data on the impact of severe acute respiratory coronavirus-2 (SARS-CoV-2) on the reproductive tissues, its possible risk of cross-contamination, transmission and adverse effect on in vitro fertilization (IVF) outcome. Until today, there is no report associated with viral RNA in both follicular fluid and embryo culture medium from SARS-COV-2 positive women. In this case report, a 24-year-old woman with SARS-CoV-2 was presented. We investigated the SARS-COV-2 positivity in the follicular fluid and embryo culture medium of mildly symptomatic woman on oocyte pick up (OPU) day. We could not detect viral RNA in neither the follicular fluid nor the embryo culture medium. In addition, although the response of ovarian stimulation was normal, the number and maturity of the retrieved oocytes were low.

Raising the awareness for insufficient oxygen delivery from self-inflating resuscitation bags lacking expiratory valve during preoxygenation

We recently read an interesting study which demonstrated that self-inflating resuscitation bag (SIRB) lacking expiratory valve has unreliable performance in oxygen delivery during spontaneous breathing mimicked by mechanical lung simulator. It was postulated that the absence of an expiratory valve and the resulting air entrainment via the exhaust port accounts for the poor oxygen delivery performance. The current disposable SIRB in-use in our institutions (Med-Rescuer Disposable BVM Resuscitator 4000, BLS Systems Limited, ON, Canada) has a duckbill valve but no expiratory valve. Safety concerns regarding its oxygen delivery performance during spontaneous breathing were raised, as this SIRB was commonly used to preoxygenate critically ill patient with potentially transmissible respiratory infection (e.g. COVID-19) before tracheal intubation. We therefore performed an experiment on this SIRB using one of us as a healthy volunteer. Our small experiment demonstrated that air entrainment could occur via the exhaust port and affect oxygen delivery performance. Our experiment also demonstrated that attaching a positive end-expiratory pressure (PEEP) valve to the exhaust port improves the oxygen delivery performance. The findings of this experiment were sent to the relevant department of our institutions for safety consideration. © The Author(s) 2022.

A portable, low-cost and high-throughput electrochemical impedance spectroscopy device for point-of-care biomarker detection

This paper presents a portable, fast and accurate electrochemical impedance spectroscopy (EIS) device with 8-well interdigitated electrode chips for biomarker detection. The design adopts low crest factor multisine signal synthesis at low frequencies (<1 kHz) and single-tone signals at high frequencies (>1 kHz), which significantly increases measurement speed without sacrificing accuracy. In addition, the low excitation amplitude of 10 mV preserves impedance linearity and protects the biosamples. The system achieved an average magnitude accuracy error of 0.30% in the frequency range of interest and it requires only 0.46 s to scan 28 frequency points from 10 Hz to 1 MHz. Experiments were conducted to test the capability to detect antibodies against SARS-CoV-2. Gold nanoparticles bound with protein G (GNP-G) were employed as the conjugated secondary antibody probe to detect anti-SARS-CoV-2 IgG in serum. A highly statistical significance (p = 7×10−6) could be found in the impedance data at 10 kHz. The impedance magnitude alteration caused by the GNP-G of the positive and negative groups were 27.2%±13.6% and 4.1%±1.7%, respectively. The results imply that the proposed system enables rapid COVID-19 antibody biomarker detection. Moreover, the EIS system and GNPs have the potential to be modified to detect other biomarkers. © 2022 The Author(s)

TELEMEDICINE FOR POST-COVID-19 MANAGEMENT OF HYPERTENSION

Worldwide, the number of telemedicine visits overall has increased after the onset of COVID19 outbreak. The pandemic has led to changes in regulations and reimbursement rules to generally favor telehealth, as well as increased public awareness and acceptance of virtual visits. In Japan, the adoption of virtual video visits has been slow, largely due to regulations and reimbursement policies. For the whole country, much less than 1% of total outpatient visits has used virtual video visits. Compared to traditional care, hypertension management using online digital solutions has a potential to improve care access and reduce untreated hypertension population. Notably, hypertension is one of the best fit conditions to be managed by virtual care among various acute and chronic illnesses because the primary index of treatment is self-measured home blood pressure and effective medications with minimal side effects are available. However, currently implemented hypertension telemedicine includes different styles of care delivery that needs to be taken into account when discussing remote hypertension management. According to a report, telephone visits and video visits had lower proportion of visits with recorded blood pressure compared to in-person visits (Ye, JMIR Formative Research, 2022). An ideal ICT-assisted management likely involves home blood pressure monitoring, team care with interactive lifestyle modification guidance, and audio-video visits. Post-COVID-19 management of Hypertension can be enriched by combining remote blood pressure monitoring and virtual visits with digital therapeutics and mHealth services promoting lifestyle modifications. The remaining challenge includes cost considerations and disparities that may arise from economic status, internet availability, and digital service familiarity. Especially for a patient population whose primary or sole health condition needing medical attention is hypertension, total care with online visits may have advantage over other forms of care, offering convenience, care effectiveness using accurate BP assessment, and good cost profile. In addition, online hypertension care employing properly-planned data structure can help generate a high-quality real-world dataset which may be used to evaluate the advances in quality of care using technologies.

THE RELATIONSHIP BETWEEN CHANGES IN EXERCISE HABITS, PHYSICAL FUNCTION, AND PSYCHOLOGICAL STATUS IN OLDER PATIENTS WITH HYPERTENSION

Objective: Self-restraint from activities due to the COVID-19 pandemic has limited the range of activities and interpersonal relationships for older persons. Moreover, prolonged restraint has been reported to increase the risk of frailty and sarcopenia. Therefore, we examined the effects of changes in exercise habits on physical function and psychological status of older patients with hypertension throughout their self-restraint lifestyle from 2020 to 2022 in the 1-year follow-up study. Design and Methods: Participants were patients with hypertension aged 65 years or older attending outpatient clinics at our institution who could obtain information on exercise habits, history of falls, comprehensive geriatric assessment, and muscle strength. We conducted the same survey in the first year and one year later. The subjects were classified into four groups by combining their exercise habits in the first year with or without one year later. That is Group A: with exercise habits at both times of the survey;Group B: with exercise habits in the first year and without exercise habits one year later;Group C: without exercise habits in the first year and with exercise habits one year later;and Group D: without exercise habits at both times of the survey. Written consent forms were obtained from all participants. Our institutional review board approved the study protocol. Results: The study participants were 183 patients (Group A: 119, Group B: 26, Group C: 17, Group D: 21). The age of the participants was 76.1 ± 5.5 years, 82 (44.8%) were male, and the duration of hypertension was 18.4 ± 11.5 years. Changes in exercise habits were not associated with physical function, history of falls, and comprehensive geriatric assessment at one year. However, when the results were examined separately for men and women, the geriatric depression scale was significantly higher in women in Group B (Dunnett test, p = 0.0094) than in Group A, suggesting that the tendency toward depression had progressed. Group B women also had more falls one year later (chi-square 12.04, p = 0.0072). Conclusions: In a 1-year follow-up study during the COVID-19 pandemic, a relatively high proportion of older patients with hypertension attending our hospital maintained their exercise habits, but 14% of cases lost their exercise habits. Only women showed the development of depression and increased risk of falls when exercise habits were lost. Women were more susceptible to the effects of environmental changes than men in older patients with hypertension.

URINARY BIOMARKER ANALYSES ON JAPANESE, MEDITERRANEAN AND EURO-WESTERN POPULATIONS: WHICH IS BETTER FOR POSTPANDEMIC LONGEVITY?

Objective: Since nutrition could extend lifespan even in stroke-prone rats developing stroke genetically, our WHO-Collaborating Center for Primary Prevention of Cardio-vascular Diseases (CVD) started world-wide hearth examination to investigate nutrition good for healthy longevity by collecting 24-hour urine (24U) samples. Design: Urinary biomarkers of nutritions, sodium for salt, potassium (K) for vegetables and fruits, isoflavones(Is) for soy, taurine(Ta) for fish and magnesium (Mg) for beans and nuts were analyzed in 24U among 4211 participants (49.7% females(F)), aged 48-56 years in 50 populations from 22 countries according to WHO-CARDIAC(Cardiovascular Diseases and Alimentary Compression) Study Protocol, and studied comparatively in 6 Japanese(J), 6 Mediterranean(M) populations from Greece, Italy(2), Spain(2), Portugal and 6 Euro-Western(EW) populations from Sweden, Ireland, Scotland, Canada, Australia, New Zealand. Results with Discussion: The quintile analyses of Ta and Mg/creatine ratio in the world were inversely associated with CVD risks. The Odds ratios of obesity, hypercholesterolemia and hypertension in the lowest quintile of both Ta and Mg were 6.3, 4.6 and 1.8, respectively. J and M populations had significantly higher Ta and Mg therefore, lower CVD risks than EW, but J and M took more salt increasing the risk of stroke (Table 1). Despite the high salt intake, M had the merit of significantly high K intake to attenuate the adverse salt effect. J had a merit to take Is from soy containing Mg. Since Is intake was inversely associated with lower BMI in the world populations, high Japanese Mg intake was related to high Is intake which was inversely associated with obesity in Japan. In fact, the Japanese populations who took significantly higher T and Mg had lower BMI as well as higher HDL and folic acid in the blood, expected to prevent atherosclerosis and dementia. In contrast to M and EW, particularly severe obesity over BMI 30 was obviously less in J, ranking 182nd among 190 populations (WHO). The mortality rates of COVID-19 were significantly positively related to the ratio of severe obesity among 20 major countries in the world and this mortality was obviously lower in J, suggestive of the potential of J diet for post-pandemic longevity. Conclusion: 24U biomarker analyses indicated low-salted J and M diets are recommendable for CVD prevention. J diet is so far better than M diet because of lower CVD risks such as obesity and lipidemia, which were proven by urinary biomarkers to be related with traditional fish and soy intakes.

EVALUATION OF THE EFFECT OF THE COVID-19 PANDEMIC ON THE TREATMENT OF RADIATION ONCOLOGY PATIENTS

Background: Patients undergoing cancer treatment and people with a history of cancer constitute a high-risk patient group in the COVID-19 pandemic. In this study, we aimed to evaluate the life effect of the COVID-19 pandemic on the treatment processes of cancer patients receiving radiotherapy at our hospital's Radiation Oncology Clinic. Methods: Sociodemographic data, COVID-19 pandemic awareness, vaccination and disease transmission of the Radiation Oncology Clinic's patients were administered with a written questionnaire that includes the effects of the pandemic on the treatment between 1st and 30th June of 2021. Results: 7 (13.2%) of the patients had COVID-19 infection during the treatment processes, the in-home index was 4 (57%) due to contact with the case (p<0.001). 4 of the patients (7.5%) stated that they had experienced disruptions in their treatment processes caused by the health institution and 4 of the patients (7.5%) stated that they had experienced disruptions in their treatment processes caused by personal anxiety and anxiety during the pandemic process. 8 patients (15%) stated that they had concerns that they would receive incomplete treatment due to the pandemic process, while one patient (1.9%) stated that they had received psychological support and psychiatric medication due to this anxiety and fear. 9 patients (17%) stated that the covid-19 pandemic had a negative effect on oncological disease treatment processes. Conclusion: It is important that the treatment and follow-up of cancer patients, who are a at-risk group for COVID-19 infection, should continue without interruption, accompanied by up-to-date national and international guidelines.