Inhaled anesthesia associated with reduced mortality in patients with stage III breast cancer: A population-based study.

BACKGROUND: Patients diagnosed with stage III breast cancer often undergo surgery, radiation therapy, and chemotherapy as part of their treatment. The choice of anesthesia technique during surgery has been a subject of interest due to its potential association with immune changes and prognosis. In this study, we aimed to compare the mortality rates between stage III breast cancer patients undergoing surgery with propofol-based intravenous general anesthesia and those receiving inhaled anesthetics. METHODS: Using data from Taiwan's National Health Insurance Research Database and Taiwan Cancer Registry, we identified a cohort of 10,896 stage III breast cancer patients. Among them, 1,506 received propofol-based intravenous anesthetic maintenance, while 9,390 received inhaled anesthetic maintenance. To ensure comparability between the two groups, we performed propensity-score matching. RESULTS: Our findings revealed a significantly lower mortality rate in patients who received inhaled anesthetics compared to those who received propofol-based intravenous anesthesia. Sensitivity analysis further confirmed the robustness of our results. CONCLUSIONS: This study suggests that inhaled anesthesia technique is associated with a lower mortality rate in clinical stage III breast cancer. Further research is needed to validate and expand upon these results.

Effect of indoor air quality on the association of long-term exposure to low-level air pollutants with cognition in older adults.

BACKGROUND: How indoor air quality affects the temporal associations of long-term exposure to low-level air pollutants with cognition remains unclear. METHODS: This cohort study (2011-2019) included 517 non-demented older adults at baseline with four repeated cognitive assessments. The time-varying exposure to PM2.5, PM10, NO2, SO2, CO, and O3 was estimated for each participant from 1994 to 2019. Indoor air quality was determined by ventilation status and daily indoor time. Generalized linear mixed models were used to analyze the association of air pollutants, indoor air quality, and cognition adjusting for important covariates. RESULTS: Over time, per 2.97 µg/m3 (i.e., an interquartile range) increment of PM2.5 was associated with the poor performance of memory (Z score of a cognitive test, ߈:-0.14), attention (߈:-0.13), and executive function (߈:-0.20). Similarly, per 2.05 µg/m3 increase in PM2.5-10 was associated with poor global cognition [adjusted odds ratio (aOR): 1.48, ߈:-0.28], attention (߈:-0.07), and verbal fluency (߈:-0.09); per 4.94 µg/m3 increase in PM10 was associated with poor global cognition (aOR: 1.78; ߈:-0.37). In contrast, per 2.74 ppb increase in O3 was associated with better global cognition (߈:0.36 to 0.47). These associations became more evident in participants with poor ventilation or short daily indoor time (<12.5 h/day). For global cognition, the exposure to a 10-µg/m3 increment in PM2.5, PM2.5-10, and PM10 corresponded to 1.4, 5.8, and 2.8 years of aging, respectively. CONCLUSION: This study demonstrated how indoor air quality in areas using clean fuels differentially affected the associations of long-term exposure to low-level air pollutants with cognition. Tightening air quality standards may help prevent dementia.

Ocurrencia de Isospora belli, Cryptosporidium spp y Cyclospora cayetanenesis en pacientes urbanos evaluados por síntomas gastrointestinales con o sin imnunosupresión / Occurrence of Isospora belli, Cryptosporidium and Cyclospora cayetanenesis spp in urban patients evaluated for gastrointestinal symptoms with or without immunosuppresion

Este estudio de corte transversal, estimó la ocurrencia de infecciones por coccidias intestinales (CI) en pacientes urbanos procedentes de Caracas-Venezuela. Se analizaron, 1 831 referencias de pacientes externos de ambos sexos y con edad promedio ± desviación estándar de 28,8 ± 22,93 años. En la Sección de Geohelmintiasis del Instituto de Medicina Tropical (SGH-IMT), se evaluaron 4 650 muestras de heces seriadas, por examen directo, formol tritón éter y Baermann, pertenecientes a 1 550 pacientes. Adicionalmente, la prueba de Ziehl-Neelsen modificada, se aplicó a las muestras fecales de 150 pacientes, por solicitud del médico tratante o sugerencia de SGH-IMT. La eosinofilia (40,54 por ciento; 225/555) constituyó el principal motivo de referencia y consulta. El promedio ± DS de contaje absoluto de eosinófilo (3 151 ± 5 161) demostró eosinofilias leves (63/204) y moderadas (25/204). Otros motivos de consulta fueron: dolor abdominal (27,72 por ciento; 122/440), náuseas/vómitos (19,03 por ciento; 83/436), pujo/tenesmo (16,05 por ciento; 70/436) y por último, la consistencia líquida de las heces (4,87 por ciento; 74/1 477). Los parasitados (43,7 por ciento; 677/1 550) presentaron evacuaciones pastosa (81,25 por ciento; 494/608) y blandas (37 por ciento; 57/608). Sólo, 5,92. por ciento (36/608) presentaron consistencia líquida. La prueba de Ziehl-Neelsen modificada demostró 12 casos positivos (8 por ciento) para CI: Isospora belli (5,33 por ciento; 8/150), Cryptosporidium spp (2 por ciento; 3/150) y Cyclospora cayetanensis (0,66 por ciento; 1/150). El único caso de ciclosporiosis estaba co-infectado con Blastocystis hominis y no presentó cambios en la consistencia de las heces. Estos resultados apoya la idea de que los médicos interconsultantes soliciten la aplicación de exámenes coproparasitológicos adicionales, en forma seriada, de bajo costo, para evaluar pacientes inmunocompetentes urbanos, con síntomas gastrointestinales/ eosinofilia, ...

These two years follow up; cross-sectional study estimates the occurrence of intestinal coccidias in urban patients from the metropolitan area of Caracas-Venezuela. One thousand eight hundred thirty one outpatient case reports were analyzed, both sex and 28.8 ± 22.93 years. Soil-transmitted helminthes laboratory of the Tropical Medicine Institute (SGH-IMT) evaluated 4 650 feces samples from 1 550 outpatients by direct, formol triton ether and Baermann techniques, Additionally, modified Ziehl-Neelsen, were done because of clinicians or SGH-IMT suggestion for 150 outpatients. Eosinophilia (40.54 percent; 225/555) was the major cause of referral and consultation. The mean of the absolute count of eosinophils (3 151+ 5 161) showed low (63/204) and moderate (25/204) eosinophila. Other causes of consultation were: abdominal pain (27.72 percent; 122/440), nausea/ vomiting (19.03 percent; 83/436), tenesmus/constipation (16.05 percent; 70/436) and finally, liquid fecal consistency (4.87 percent; 74/1477). Parasite infected patients (43.7 percent; 677/1550) had normal (81.25 percent; 494/608) and semi liquid feces (37 percent; 57/608). Only, 5.92 percent (36/608) had liquid consistency. Modified Ziehl-Neelsen demonstrates 12 positive IC (8 percent) for: Isospora belli (5.33. percent; 8/150), Cryptosporidium spp (2 percent; 3/150) and Cyclospora cayetanensis (0.66 percent; 1/150). The only case of cyclosporidiosis was co-infected with Blastocystis hominis and had normal feces. These results agrees with the idea for clinicians to ask for additional, low cost, serial parasitological test in feces, to evaluate urban inmunocompetent outpatients, with gastrointestinal symptoms/eosinophilia, even without diarrhea, because the basic feces techniques, used routinely, fails to make the precise parasite diagnostic, underestimating coccidiosis