Decreased numbers of gastric, colorectal, lung, and breast cancer surgeries performed in 17 cancer-designated hospitals in Gunma Prefecture of Japan during the COVID-19 pandemic.

PURPOSE: This study aims to clarify the influence of the COVID-19 pandemic on cancer surgery in Gunma Prefecture. METHODS: A total of 9839 cases (1406 gastric cancer, 3569 colorectal cancer, 1614 lung cancer, and 3250 breast cancer) from 17 hospitals in Gunma Prefecture were investigated. We compared the number of surgical cases, proportion of cases found by screening, and cStage at the time of the first visit by month in 2020 and 2021 with those in 2019. RESULTS: The rate of decline in cancer surgery was 8.9% in 2020 compared with 2019 (p = 0.0052). Compared with the same month of 2019, in some months of 2020 and 2021, significant decreases were observed in the number of surgeries for gastric and colorectal cancer, the percentage of surgical cases detected by screening in all four cancers, and the proportion of cancers with a relatively early cStage in gastric and breast cancer. CONCLUSIONS: The number of surgical cases of the four cancer types detected by cancer screening decreased in Gunma Prefecture owing to the influence of the COVID-19 pandemic. Furthermore, for some cancer types, the number of operations performed in patients with early-stage cancer is also decreased.

Pulse Amplitude Measured with a Portable Laser Doppler Flowmeter Is Useful for Screening of Dialysis Patients for Peripheral Arterial Disease: An Observational Study.

Objective: The objective of this study was to use a portable laser Doppler flowmeter (LDF) to measure the toe blood flow and pulse amplitude as a screening test for peripheral arterial disease (PAD) in dialysis patients and compare the diagnostic abilities of the aforementioned parameters measured using an LDF with those of the ankle-brachial index (ABI) and toe brachial index (TBI). Methods: The 14 patients in this retrospective study received maintenance hemodialysis (HD). We measured the blood flow and pulse amplitude on the ventral side of the first toe with a portable LDF while the patients were undergoing an HD session. The correlations between the blood flow/pulse amplitude in the toe and the ABI/TBI were examined. Results: Both the ABI and TBI had a strong correlation with pulse amplitude. The sensitivity and specificity of the pulse amplitude measured with the LDF for detecting PAD in HD patients as determined by a receiver operating characteristic curve analysis were 1.00 and 0.88, respectively. Conclusion: Measuring the pulse amplitude in the toe with a portable LDF may serve as a simple and useful screening test for PAD in HD patients.

Outcomes of Intermittent Infusion Hemodiafiltration in Patients with Cardiac Hypofunction on Maintenance Hemodialysis.

BACKGROUND: Following the onset of heart failure symptoms, fluid removal is usually intensified, but patients with decreased cardiac function may develop sudden hypotension due to poor plasma refilling and functional impairment of the mechanisms that maintain blood pressure. In these patients, removal of fluids then becomes difficult. Impairment of the mechanisms that maintain blood pressure can be treated with vasopressors, but intermittent infusion hemodiafiltration (I-HDF) may be effective for managing poor plasma refilling. Thus, here I-HDF was performed in patients with cardiac hypofunction who were undergoing maintenance hemodialysis (HD) in order to assess the clinical effects. SUMMARY: Participants were 5 patients with cardiac hypofunction on maintenance HD. HD and I-HDF were performed for a total of 6 months each. A comparison was made of changes in dry weight (DW) and cardiothoracic ratio (CTR), blood test results, echocardiography findings, plasma -refilling rate (PRR), and tissue blood flow. During I-HDF, a decrease in DW was achieved and CTR was significantly improved. Echocardiographic findings showed that left ventricular diameter improved significantly during I-HDF. Higher PRR values and increased tissue blood flow were -observed during I-HDF compared with HD. Intermittent infusions during I-HDF prevented organ ischemia and suppressed the De Jager-Krogh phenomenon. This may be associated with the promotion of stable plasma refilling. Key Messages: Excessive fluid retention is a cause of heart failure symptoms. I-HDF facilitates removal of excessive fluid and thereby possibly contributes to the improvement of cardiac function.