Patient navigation pathway and barriers to treatment seeking in cancer in India: A qualitative inquiry

Cancer is a leading cause of mortality worldwide. Early diagnosis and treatment of cancer may curb the growing burden of the disease. Understanding cancer patients’ navigation pathways for seeking treatment is important in order to facilitate early diagnosis and treatment. With this background we conducted a hospital-based cross-sectional study comprising 68 randomly selected cancer inpatients in a tertiary cancer specialty hospital in Odisha, India, to explore the treatment-seeking pathways of the cancer patients and the barriers and enablers in seeking treatment. Financial constraint is one of the major reasons for the delay in accessing treatment, even when patients are suspected of or diagnosed with cancer. Low awareness of the presenting signs and symptoms of cancer and limited knowledge of the availability of cancer diagnosis and treatment facilities are major factors contributing to delay. Family and friends’ support is found to be the major enabling factor toward seeking treatment. Generation of awareness of cancer among the general population and primary-care practitioners – including those in alternative systems of medicine – is important. Information on diagnostic and treatment services appears to be a felt need.     

开放性骨折患者发生医院感染的临床特征及危险因素分析

目的:研究开放性骨折患者发生医院感染的临床特征及危险因素,为降低院内感染提供临床参考。方法:回顾性分析于2013年3月-2015年3月间院内收治的1860例开放性骨折患者临床资料,对存在院内感染患者的感染类型、病原菌类型及相关危险因素进行分析,应用SPSS19.0统计软件对数据进行研究。结果:1860例患者中共计65例出现医院感染情况,发生率为3.49%,感染类型主要为骨髓炎占35.38%,肺部感染伴血气胸占23.08%,颌面部创伤后发生颅内感染占18.46%;65株病原菌中包括38株革兰氏阴性菌,占58.46%,23株革兰氏阳性菌,占35.38%,4株真菌,占6.15%;病程、骨折部位、损伤程度及住院时间为开放性骨折医院感染的独立危险因素,差异具有统计学意义(P0.05)。结论:通过分析开放性骨折患者医院感染的临床特征及危险因素,有利于医院防治工作的开展,为医院感染防治提供理论支持,具有重要指导意义。     

埃博拉病毒检测与防治技术在中国的专利申请状况分析

近年来,埃博拉病毒(EBOV)因其在非洲造成的严峻疫情而引起了广泛关注。本文对涉及埃博拉病毒检测与防治技术方面的在中国申请的国内外专利申请数量、年代分布、技术发展状况等信息进行分析,对国内埃博拉病毒检测、免疫、治疗相关专利技术进行简要总结,并对目前热点关注药物(jk-05,ZMapp,VSV-EBOV)专利申请信息进行比较概括,结果表明,我国申请人在提出的相关专利申请数量以及技术多样性上与国外申请人存在差距,为国内科研人员提供了相关技术领域参考。     

拉沙热研究进展

拉沙热(Lassa fever,LF)由拉沙病毒(Lassa virus,LASV)引起,是一种通过鼠类传播给人的急性出血性动物源性传染病,病死率高。主要在西非地区流行,但在全球多个国家发现输入性病例。本文主要针对拉沙病毒的病原学特点、疾病流行现状、临床特征、实验室检测、治疗及预防进展进行综述。同时,建议在全球经济一体化的大形势下,加强对拉沙热国际防控的关注度,建立国际联防联控防治策略和措施,并将其纳入全球防控体系。     

An enzyme combination assay for serum sphingomyelin: Improved specificity through avoiding the interference with lysophosphatidylcholine

Serum sphingomyelin (SM) has predictive value in the development of atherosclerosis. Furthermore, SM plays important roles in cell membrane structure, signal transduction pathways, and lipid raft formation. A convenient enzymatic method for SM is available for routine laboratory practice, but the enzyme specificity is not sufficient because of nonspecific reactions with lysophosphatidylcholine (LPC). Based on the differential specificity of selected enzymes toward choline-containing phospholipids, a two-step assay for measuring SM was constructed and its performance was evaluated using sera from healthy individuals on a Hitachi 7170 autoanalyzer. Results from this assay were highly correlated with theoretical serum SM concentrations estimated by subtracting phosphatidylcholine (PC) and LPC concentrations from that of total phospholipids determined using previously established methods. There was a good correlation between the results of SM assayed by the proposed method and the existing enzymatic method in sera from healthy individuals. Moreover, the proposed method was superior to the existing method in preventing nonspecific reactions with LPC present in sera. The proposed method does not require any pretreatment, uses 2.5 μl of serum samples, and requires only 10 min on an autoanalyzer. This high-throughput method can measure serum SM with sufficient specificity for clinical purposes and is applicable in routine laboratory practice.     

44例不同孕周脐带脱垂患者的临床资料分析

目的:探讨不同孕周脐带脱垂患者相关因素的差异。方法:回顾性比较分析2012年01月至2017年12月我院收治的44例脐带脱垂患者的临床资料。将患者按照脐带脱垂发生的孕周分为足月组、早产组及流产组,使用SPSS18.0统计软件处理数据。结果:我院近六年脐带脱垂总的发病率为1.829/1000。44例患者中,足月组7人,占15.91%;早产组22人,占50%;流产组15人,占34.09%。三组患者的年龄、产次及孕次均无显著统计学差异(P0.05)。足月组新生儿apgar评分最高,与其它两组相比均有统计学差异(P0.05),早产组apgar评分显著高于流产组(P0.05);足月组剖宫产率为100%,早产组为63.64%,流产组则为13.13%,三组患者剖宫产率比较存在统计学差异(P=0.000),足月组剖宫产率与早产组比较无统计学差异(P=0.075),足月组剖宫产率与流产组比较有统计学差异(P=0.000),早产组剖宫产率与流产组比较有统计学差异(P=0.003)。足月组异常胎方位的发生率显著低于早产组(P=0.038)。早产组胎儿数(单胎、双胎)与足月组及流产组相比均有统计学差异(P0.05),而足月组与流产组胎儿数则无统计学差异(P0.05)。早产组双胎妊娠占比例更高。三组患者发生脐带脱垂的地点比较无统计学差异(P=0.256)。结论:不同孕周是否发生脐带脱垂与患者的年龄、产次、孕次及地点无关。脐带脱垂较多发生于早产者,且早产患者中双胎、异常胎方位发生率更高。一旦发生脐带脱垂,尤其是有机会存活的胎儿,应以最快的方式娩出胎儿,提高新生儿存活几率。     

Immunomodulation of carcinogens-induced steroids-dependent human diseases

The experimental and clinical data about antibodies against environmental chemical carcinogens and endogenous steroids are represented. The conception of immunomodulation of carcinogens- and steroids-dependent human diseases is proposed. It is postulated that antibodies to polycyclic aromatic hydrocarbons and heterocyclic amines in cooperation with antibodies to cholesterol, sex hormones, mineralo- and glucocorticoids stimulate or inhibit cancer, malformation, cardiovascular and autoimmune diseases depending on their personal combination. It is recommended to use immunoassay of these antibodies for the human diseases prediction. The alternative approaches for prevention using the probiotics transformed by anti-carcinogen antibodies are substantiated.     

New insights into the binding mode of pyridine-3-carboxamide inhibitors of E. coli DNA gyrase

Previously we have reported on a series of pyridine-3-carboxamide inhibitors of DNA gyrase and DNA topoisomerase IV that were designed using a computational de novo design approach and which showed promising antibacterial properties. Herein we describe the synthesis of additional examples from this series aimed specifically at DNA gyrase, along with crystal structures confirming the predicted mode of binding and in vitro ADME data which describe the drug-likeness of these compounds.     

Cancers in France in 2015 attributable to insufficient physical activity

IntroductionInsufficient physical activity is a known risk factor for various co-morbidities, including cancer. Globally, its prevalence has increased markedly over the past decades. The aim of this study was to estimate the proportion and number of cancers that were attributable to insufficient physical activity in France in 2015.MethodsPopulation attributable fractions (PAFs) and numbers of cancer cases attributable to insufficient physical activity (<30 min daily of moderate-to-vigorous physical activity) were estimated by age, sex and cancer site. Assuming a 10-year lag-period, PAFs were calculated using physical activity prevalence from a cross-sectional French population survey and cancer-specific relative risks.ResultsAbout half of all French adults were found to be insufficiently physically active, with great variation by age and sex. In 2015, an estimated 2973 cancer cases diagnosed in French adults aged 30y+ were attributable to insufficient physical activity, corresponding to 0.8% of all cancer cases (0.2% in men and 1.6% in women). This comprised 3.8% of all postmenopausal breast cancers (1620 cases), 3.6% of all colon cancers (902 cases) and 6.0% of all cancers of the corpus uteri (450 cases). If at least half of the recommended physical activity level was achieved, 1095 cancer cases could have been avoided.ConclusionInsufficient physical activity is associated to about 3000 cancer cases in France, a country with comparatively low but increasing prevalence of this risk factor. This result is important for setting priorities in cancer prevention programmes aiming to increase physical activity in France and Europe in general.     

Implementation of hypocalcaemia prevention programmes in commercial dairy herds: From theory to practice

Hypocalcaemia prevention programmes have been widely studied in experimental settings, but their feasibility has not been assessed under field conditions. The main objective of this study was to evaluate, in the context of small dairy farms in western France, whether and how dairy farmers implement prevention programmes and manage the feeding of dry cows to prevent hypocalcaemia. Seventy-nine commercial Holstein dairy farms in Brittany (France) were enrolled in a qualitative study in 2019. We conducted in-person interviews with the farmers to 1) understand the rationale behind the type and seasonality of prevention programmes they implemented and 2) assess how closely they followed common recommendations when implementing them. Most farmers (80 %) used at least one prevention programme, especially supplying a mineral mix formulated to meet the needs of dry cows in late gestation (53 %), acidifying the diet in late gestation (37 %), and supplying calcium at calving (oral or injectable form, 37 %). The use of programmes depended on whether the diet composition varied throughout the year. Among farmers who provided an acidified diet, 25 % did not supply a specific mineral mix to dry cows to ensure an adequate amount of P, Ca, and Mg, which could decrease the effectiveness of the acidification programme. A lack of reliability in feeding practices, such as not weighing feed or not delivering feed frequently enough, was identified for 61 % of contributing farms. Management practices could result in supplying an unsuitable amount of P, Ca, or Mg immediately before calving; for example, inappropriate batching practices around calving were identified for 22 % (cows) to 32 % (heifers) of farms. In addition, nearly all contributing farmers had no processes in place to monitor the effectiveness of the programmes implemented. Reasons for this overall lack of compliance should be explored.