Cravenschou5009

rces of drug-resistant bacteria and ESBL genes. https//doi.org/10.1289/EHP7729.More than 40 years after the 1978 Bethesda Conference on the Declining Mortality from Coronary Heart Disease provided the scientific community with a blueprint for systematic analysis to understand declining rates of coronary heart disease, there are indications the decline has ended or even reversed despite advances in our knowledge about the condition and treatment. Recent data show a more complex situation, with mortality rates for overall cardiovascular disease, including coronary heart disease and stroke, decelerating, whereas those for heart failure are increasing. To mark the 40th anniversary of the Bethesda Conference, the National Heart, Lung, and Blood Institute and the American Heart Association cosponsored the "Bending the Curve in Cardiovascular Disease Mortality Bethesda + 40" symposium. The objective was to examine the immediate and long-term outcomes of the 1978 conference and understand the current environment. Symposium themes included trends and future projections in cardiovascular disease (in the United States and internationally), the evolving obesity and diabetes epidemics, and harnessing emerging and innovative opportunities to preserve and promote cardiovascular health and prevent cardiovascular disease. In addition, participant-led discussion explored the challenges and barriers in promoting cardiovascular health across the lifespan and established a potential framework for observational research and interventions that would begin in early childhood (or ideally in utero). This report summarizes the relevant research, policy, and practice opportunities discussed at the symposium.

Sixteen percent (16%) of patients with castration-resistant prostate cancer (CRPC) show no bone metastasis at diagnosis. However, 33% will become metastatic within 2 years. The goal of treatment in patients with nonmetastatic CRPC (nmCRPC), therefore, is to delay symptomatic metastases without undue toxicity. With novel antiandrogen treatments of different strengths and limitations available, physician preferences for nmCRPC treatment in Japan should be understood.

A discrete choice experiment was conducted. Physicians chose between two hypothetical treatments in nmCRPC defined by six attributes risk of fatigue, falls or fracture, cognitive impairment, hypertension, rashes as side effects of treatment, and extension of time until cancer-related pain occurs. Relative preference weights and relative importance were estimated by hierarchical Bayesian logistic regression. Physicians were also asked to make treatment decisions based on four hypothetical patient profiles to understand the most important factorsd a treatment with better safety profile, and treatment characteristics were the most important factors for decision making. This might have implications in physicians' decision making for nmCRPC treatment in the future in Japan.

There has been noteworthy concern about the impact of COVID-19 pandemic on health services including the management of cancer. In addition to being considered at higher risk for worse outcomes from COVID-19, people with cancer may also experience disruptions or delays in health services. This systematic review aimed to identify the delays and disruptions to cancer services globally.

This is a systematic review with a comprehensive search including specific and general databases. We considered any observational longitudinal and cross-sectional study design. The selection, data extraction, and methodological assessment were performed by two independent reviewers. The methodological quality of the studies was assessed by specific tools. The delays and disruptions identified were categorized, and their frequency was presented.

Among the 62 studies identified, none exhibited high methodological quality. The most frequent determinants for disruptions were provider- or system-related, mainly because of the redlays and disruptions in health care mostly related to the reduction of the COVID-19 burden unintentionally posed a major risk on cancer care worldwide. Strategies can be proposed not only to mitigate the main delays and disruptions but also to standardize their measurement and reporting. As a high number of publications continuously are being published, it is critical to harmonize the upcoming reports and constantly update this review.

Prostate cancer (PCa) becomes resistant to androgen ablation through adaptive upregulation of the androgen receptor in response to the low-testosterone microenvironment. Bipolar androgen therapy (BAT), defined as rapid cycling between high and low serum testosterone, disrupts this adaptive regulation in castration-resistant PCa (CRPC).

The TRANSFORMER (Testosterone Revival Abolishes Negative Symptoms, Fosters Objective Response and Modulates Enzalutamide Resistance) study is a randomized study comparing monthly BAT (n = 94) with enzalutamide (n = 101). The primary end point was clinical or radiographic progression-free survival (PFS); crossover was permitted at progression. Secondary end points included overall survival (OS), prostate-specific antigen (PSA) and objective response rates, PFS from randomization through crossover (PFS2), safety, and quality of life (QoL).

The PFS was 5.7 months for both arms (hazard ratio [HR], 1.14; 95% CI, 0.83 to 1.55;

= .42). For BAT, 50% decline in PSA (PSA50) was enzalutamide can improve survival in men with CRPC.

This randomized trial establishes meaningful clinical activity and safety of BAT and supports additional study to determine its optimal clinical integration. BAT can sensitize CRPC to subsequent antiandrogen therapy. Further study is required to confirm whether sequential therapy with BAT and enzalutamide can improve survival in men with CRPC.

To determine the differential diagnosis of intra-articular tumours and tumour-like lesions in a paediatric population compared to adults.

Retrospective review of children up to the age of 18 years with suspected intra-articular tumours and tumour-like lesions referred to a specialist musculoskeletal oncology service from January 2019 to August 2020. Data recorded included patient age and gender, lesion location and morphology (based on the classification system of Adams et al.), and the final diagnosis made either by image-guided biopsy/resection or by clinical and imaging features. Comparison was then made with a group of adults presenting during the same period.

28 paediatric patients were included (12 males and 16 females with mean age 11.2 years, range 3-18 years). Joints involved were the knee (

= 22; 78.6%), ankle (

= 4; 14.3%), hip (

= 1; 3.6%) and elbow (

= 1; 3.6%). Lesion morphology was Type 1 (

= 18; 64.3%), Type 2 (

= 3; 10.7%), Type 3 (

= 1; 3.6%) and Type 4 (

= 5; 17.9%). Fjuvenile idiopathic arthritis were the next commonest diagnoses in children, while primary synovial chondromatosis and reactive synovitis were the next commonest diagnoses in adults. Malignant lesions are rare in both groups.

In our series, ~16% of tumours and tumour-like lesions of joints occur in the paediatric population. Tenosynovial giant cell tumour remains the commonest diagnosis in children as in adults. Synovial haemangioma and juvenile idiopathic arthritis were the next commonest diagnoses in children, while primary synovial chondromatosis and reactive synovitis were the next commonest diagnoses in adults. Malignant lesions are rare in both groups.

Breast cancer (BC) is the leading malignancy among Sudanese women. Yet, data on survival are limited. This study aimed to determine 5-year overall survival (OS) of BC in Sudanese women, and identify prognostic demographic and clinicopathologic factors.

A hospital-based retrospective study was conducted by reviewing data of women with BC diagnosed and treated at the National Cancer Institute-University of Gezira during 2012, and followed up to end of August 2018. Sovleplenib molecular weight Data were retrieved from medical records and analyzed, OS was determined, and the prognostic factors were explored.

A total of 225 cases were recruited. The median age at presentation was 45 years (range, 22-85 years). Clinical stage I, II, III, and IV represented 3.1%, 31.6%, 48%, and 17.3%, respectively. Most women (81.3%) were treated with curative intent. Of those, 25.1% received neoadjuvant chemotherapy. Mastectomy was the commonest (61.7%) type of surgery. The median follow-up period was 59.8 months with mean OS time of 55.7 months. The 5-these patients.

To assess the feasibility of whole-body dual-energy computed tomographic angiography (DECTA) at 40 keV with 50% reduced iodine dose protocol.

Whole-body CTA was performed in 65 patients; 31 of these patients underwent 120 kVp single-energy computed tomographic angiography (SECTA) with standard iodine dose (600 mgI/kg) and 34 with 40 keV DECTA with 50% reduced iodine dose (300 mgI/kg). SECTA data were reconstructed with adaptive statistical iterative reconstruction of 40% (SECTA group), and DECTA data were reconstructed with adaptive statistical iterative reconstruction of 40% (DECTA-40% group) and 80% (DECTA-80% group). CT numbers of the thoracic and abdominal aorta, iliac artery, background noise, signal-to-noise ratio (SNR), and arterial depiction were compared among the three groups. The CT dose index volumes (CTDI

) for the thorax, abdomen, and pelvis were compared between SECTA and DECTA protocols.

The vascular CT numbers and background noise were found to be significantly higher in DECTA groups td with SECTA with standard iodine dose.

DECTA enables 50% reduction of iodine dose while maintaining image quality, arterial depiction in almost all arteries, vascular CT numbers, and SNR; however, it does not allow clear visualization of intrapelvic arteries, requiring a slightly larger radiation dose compared with SECTA with standard iodine dose.

Olfactory function of patients with chronic kidney disease (CKD) has been found to be defective, and patients are often unaware of it. This predisposes them to malnutrition with consequence on health recovery and quality of life.

To assess the olfactory function and determine the pattern of olfactory dysfunction in patients with CKD attending the University College Hospital, Ibadan.

This was a prospective, hospital-based case-control study of adult patients with CKD. The control group were age- and sex-matched individuals without CKD. Olfactory threshold (OT), odor discrimination (OD), and odor identification (OI) tests were carried out in participants using the "Sniffin Sticks."

There were 100 patients with CKD and 100 healthy controls, age ranges between 19 to 86 years (mean ± SD = 46.3 ± 13.9 years) and 20 to 85 years (mean ± SD = 43.4 ± 14.9 years), respectively. There was no statistically significant difference between cases and control gender distribution (

= .57). The mean olfactory scores were significantly lower among the cases than control, OI 11.2 ± 2.3 and 13.1 ± 1.2 (

< .001), OD 8.5 ± 2.4 and 10.9 ± 1.5 (

< .001), OT 6.4 ± 2.5 and 9.6 ± 1.9 (

< .001), and threshold discrimination and identification 26.0 ± 5.7 and 33.6 ± 3.3 (

< .001), respectively. Prevalent olfactory dysfunction among patients with CKD was 77% (hyposmia 72%, anosmia 5%), and the control was 16% (all hyposmia;

< .001).

There was high prevalence of olfactory dysfunction among patients with CKD, and the affectation is more at the central olfactory pathway.

There was high prevalence of olfactory dysfunction among patients with CKD, and the affectation is more at the central olfactory pathway.