Peripheral Artery Disease Causes More Harm to Patients than COVID-19.

Background: To optimize our strategic planning, we aimed to investigate the impact of the COVID-19 pandemic on the treatment of patients with peripheral artery disease (PAD) at our tertiary care hospital. Methods: We performed a retrospective single-center cohort study. In total, 1210 patients were included: 611 patients admitted between March and December 2020, compared to retrospective data from 599 patients from the same period in 2019. Results: Emergency admissions involving patients with advanced stage PAD increased significantly during the pandemic period of 2020, compared to the same period in 2019 (p < 0.0098). This increase was accompanied by increased limb amputations performed during the first lockdown, post-lockdown and the second lockdown in 2020, compared to respective time periods in 2019 (p < 0.0003, p < 0.0004, p = 1). No SARS-CoV-2 infection was observed among patients with PAD during the observation period. Conclusions: Strict lockdown protocols adversely affected the care of PAD patients, with persisting aftereffects, including increased emergency admission with unsuccessful revascularization attempts leading to limb amputation, even after the peak of the pandemic had passed. We believe that providing continuous care to PAD patients, even in times of global pandemics, will prevent the unfavorable outcomes observed during the COVID-19 pandemic in 2020.

Pilot study: volatile organic compounds as a diagnostic marker for head and neck tumors.

BACKGROUND: In the last decade, the analysis of volatile organic compounds (VOC) has undergone a rapid development. In this pilot study, patients with HNSCC were tested with a proton transfer reaction-mass spectrometry in order to establish a minimal invasive screening method. METHODS: Overall in a period of 2 years, 22 carcinoma patients were recruited for the study. All patients had a newly diagnosed histologically secured squamous cell carcinoma of the upper aerodigestive tract. These results were statistically compared with 3 control groups: healthy controls, high-risk, and posttherapy patients. RESULTS: Two hundred nine different masses were measured; 188 of these were evaluated. The statistical workup of the 4 study groups produced 42 different masses, which showed a statistically significant difference from the carcinoma group compared with the control groups. CONCLUSION: A screening method for HNSCC using VOC seems to be possible, but further investigation is necessary.

Urinary acetonitrile concentrations correlate with recent smoking behaviour.

OBJECTIVES: To assess the concentration of acetonitrile (a saturated aliphatic nitrile) in the urine of habitual cigarette smokers and non-smokers, as exposure to smoke can be measured by monitoring ambient air or by in vivo tests, but acetonitrile measured in exhaled breath is reportedly a quantitative marker of recent smoking behaviour. SUBJECTS AND METHODS: The study included 101 volunteers (57 men and 44 women, mean age 49 years). An absence of urinary tract infection on urine analysis or clinical history was mandatory. The subjects were classified into five groups, i.e. a control group of non-smokers and four groups according to the number of cigarettes smoked daily. Urine samples were stored at 8 degrees C until acetonitrile was measured, within 24 h of collection, using proton-transfer reaction mass spectrometry (PTR-MS). Each measurement was repeated at least 10 times, and the mean used for statistical analysis. RESULTS: The mean (sd) acetonitrile level in the urine of 46 non-smokers was 3.74 (1.78) parts per billion volatile (ppbv). The concentration of acetonitrile increased with the number of cigarettes smoked daily, the highest concentration being in the subgroup of 13 very heavy smokers (>30 cigarettes/day) with means up to 28.04 (5.38) ppbv. CONCLUSION: PTR-MS is a quick, noninvasive online method for determining urinary acetonitrile levels, a marker for recent active and passive smoking behaviour, and thus for checking compliance. As smoking has been shown to affect the genesis of bladder cancer, further studies are required to determine the association of acetonitrile with bladder cancer.