Medicina
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Backgroundand Objectives: Gestational diabetes mellitus (GDM) is a pregnancy-associated pathology commonly resulting in macrosomic fetuses, a known culprit of obstetric complications. We aimed to evaluate the potential of umbilical cord biometry and fetal abdominal skinfold assessment as screening tools for fetal macrosomia in gestational diabetes mellitus pregnant women. Materials and methods: This was a prospective case−control study conducted on pregnant patients presenting at 24−28 weeks of gestation in a tertiary-level maternity hospital in Northern Romania. ⋯ The second-trimester abdominal circumference was statistically significantly correlated with fetal macrosomia at term in the GDM patient group with a p value of 0.003, as well as when considering the global prevalence of macrosomia in the studied populations, 0.001, when considering both populations. Conclusions: The measurements of cord and WJ could not be established as predictors of fetal macrosomia in our study populations, nor differentiate between pregnancies with and without GDM. Abdominal skinfold measurement and abdominal circumference measured during the second trimester may be important markers of fetal metabolic status in pregnancies complicated by GDM.
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Background and Objectives: The aim of this study was to determine the point prevalence of at least mild anxiety symptoms and symptoms of generalized anxiety disorder in the Latvian general population, and to analyze the associated factors. Materials and Methods: A computer-assisted face-to-face survey was conducted in 2019−2020 with a multistage stratified probability sample of the Latvian general adult population (n = 2687). Anxiety was assessed using the 7-item Generalized Anxiety Disorder (GAD-7) scale; a score of ≥5 was defined as indicating the presence of mild symptoms of anxiety, and a score of ≥10 as the cutoff for identifying cases of generalized anxiety disorder. ⋯ Conclusions: Young age, poor self-rated health, and comorbid symptoms of depression and suicidal behavior were significant factors associated with symptoms of both mild anxiety and generalized anxiety disorder. Being unmarried, living in the capital city or rural areas, and alcohol use disorder were associated with mild anxiety symptoms alone. Female sex was associated with generalized anxiety disorder symptoms alone.
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The purpose of this study is to evaluate Italian surgeons' behavior during knee arthroplasty. ⋯ Italian surgeons perform TKA more commonly than UKA. Pre-operative TKA planning is quite uniform rather than UKA planning. Despite literature evidence, there is no agreement on follow-up. It may be useful to create a uniform checklist, including correct timing and exams needed. This analysis is also part of a society surgical educational project for training doctor.
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Meta Analysis
Impacts of Outdoor Particulate Matter Exposure on the Incidence of Lung Cancer and Mortality.
Background and objectives: Long-term exposure to air pollution has been associated with lung cancer. This study aimed to evaluate the relative risk (RR) and hazard ratio (HR) of lung cancers and the prognostic implication of outdoor particulate matter (PM) pollution using a meta-analysis. Materials and Methods: We performed the meta-analysis using 19 eligible studies and evaluated the PMs, dividing into PM smaller than 2.5 µm (PM2.5) and PM smaller than 10 µm (PM10). ⋯ The lung-cancer-specific mortality was significantly increased by PM10 per 12.1 μg/m3 increment and in the Europe area. Conclusions: PM2.5 significantly increased lung cancer and the all-cause and lung-cancer-specific mortalities, whereas PM10 did not increase lung cancer or lung-cancer-specific mortality. However, PM10 increased the all-cause mortality and the PM10 per 12.1 μg/m3 increment and PM10 in the Europe area may increase the lung-cancer-specific mortality.
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Most patients suffering from neoplastic diseases will at some point during their illness be approached surgically. Surgery itself may be unfortunately responsible for tumor proliferation and metastatic spread. ⋯ There is an abundance of retrospective studies and very few prospective ones that tackled this issue. The aim of this article is to review the current state of the evidence on general anesthesia involving volatile and intravenous agents as substrates, focusing on halogenated inhalational agents and propofol, to guide clinical decision making in assessments of the best practice for perioperative management of cancer surgery.