Melanoma is a treatable and preventable skin cancer. It is responsible for 75% of deaths among all skin cancers. Previous studies have found that race/ethnicity may play a role in survival among melanoma patients. However, there are no studies that cover 30 years and take race into account for the U.S. population.This study is a secondary analysis of the National Cancer Institute's Surveillance, Epidemiology, and End Result (SEER) Program. Adults with primary cutaneous melanoma from 1982 to 2011 were included; the final sample size was 185,219. The outcome was survival; both cause-specific and all-cause mortality were examined. The main exposure was race/ethnicity. Kaplan–Meier survival analysis was used to estimate overall survival. Cox proportional hazards regression was used to estimate unadjusted and adjusted hazard ratios (HRs). A P-value less than 0.05 was considered statistically significant.More than 50% of patients in all races/ethnicities were diagnosed at the in situ or localized stage. Non-Hispanic White patients were more frequently diagnosed at the in situ stage. Overall, more men were diagnosed than women. The majority of cases among all races were men. Non-Hispanic Black females represented the smallest percentage of melanoma cases among all races. The smallest number of diagnoses across all races/ethnicities was made from 1982 to 1991. Median follow-up was 81 months and no collinearity was observed in the adjusted models. When examining cause-specific mortality and controlling for site and stage at diagnosis, gender, age and decade of diagnosis, the HR for non-Hispanic Black patients was lower than that for non-Hispanic White patients (HR 0.7; 95% confidence interval (CI): 0.6–0.8). However, when examining all-cause mortality, this difference disappeared (HR 1.1; 95% CI: 1.0–1.2). Stage at diagnosis impacted HR; patients diagnosed with distant metastases had significantly worse survival.When taking cause-specific mortality into consideration and after controlling for stage and site at diagnosis, gender, and age and decade of diagnosis, non-Hispanic Black patients had a lower HR compared to non-Hispanic White patients. However, this difference disappeared when examining all-cause mortality. Further research is needed to explore this finding and to determine what factors may be associated with late-stage melanoma diagnosis.
The knowledge and practice among CL users was less than desired. Those using contact lens for cosmetic purpose and procuring them without prescription need special focus for health promotion so that their CL related practice improve and eye complications are reduced.
Objectives This study aimed to determine the prevalence of symptoms and risk of obstructive sleep apnoea (OSA) and to identify the risk factors associated with OSA among old Saudis. Methods In this population-based survey, we administered the Saudi National Survey for Elderly Health to old Saudis between 2006 and 2007. Symptoms of OSA and its associated risk factors were determined using the Berlin questionnaire. A multivariable logistic regression analysis was used to determine key factors associated with the risk of OSA. Results Out of 2946 participants, 1544 (52.4%) were at high risk of OSA, with women having a higher risk than men (60.8% vs. 44.2%, respectively; p -value <0.001). Obesity was higher among women than men (40.5% vs. 24.8%, respectively; p -value <0.001). Almost 56% of the participants reported snoring as a risk factor, but there was no statistical difference between women and men (57.3% vs. 53.5%, respectively; p -value = 0.317). The factors identified as independent predictors of a high risk of OSA were the female gender (OR 1.732, 95% CI [1.375–2.182]), living in rural areas (OR 1.384, 95% CI [1.094–1.750]), severe cognitive impairment (OR 2.709, 95% CI [1.350–5.436]), depression (OR: 1.432 95%CI [1.147–1.789]), and antidepressants usage (OR 2.959, 95% CI [1.402–6.244]). Conclusion This study reported a 52.4% prevalence of a high risk of OSA. Women were more likely to be at high risk of OSA than men. In addition to the female gender, depression, antidepressant usage, severe cognitive impairment, and living in rural areas were main predictors of OSA.
Objectives: To evaluate the available evidence of natural honey and its effect on improving lipid profiles among the adult population. Methods: The following databases were searched in May 2020 for randomized controlled trials (RCTs) and crossover studies without any restrictions in language, publication year, or status: CENTRAL, Embase Elsevier, ClinicalTrials.gov, MEDLINE, the WHO International Clinical Trials Registry Platform, and Google Scholar. We included all RCTs and crossover studies that studied the effect of natural honey on improving lipid levels in individuals at any age, for any dose and duration. Trials investigated the intake of honey alone or honey dissolved in water. The comparison groups were no intervention or placebo. Two independent reviewers screened and evaluated the included trials. The third reviewer was involved in resolving any disagreement. Our aim was to evaluate the evidence available regarding the effect of natural honey in improving lipid profile. Results: Seven trials with 370 participants fitted the inclusion criteria. Pooled analysis showed, honey was found to reduce total cholesterol levels with statistical significance (mean difference [MD]: -14.97 mg/dl, 95% CI: 19.61 to -10.32). Honey was associated with a statistically significant increase in high-density lipoprotein (HDL) levels (MD: 1.78 mg/dl, 95% CI: 0.68 to 2.88). There was a statistically significant LDL reduction level (MD: 18.99 mg/dl, 95% CI: -22.79 to -15.20). Finally, honey was found to lower triglyceride levels significantly (MD: 9.68 mg/dl, 95% CI: -15.56 to -3.80). Conclusions: Total cholesterol was significantly reduced with the use of natural honey intake, as well as low-density lipoprotein (LDL), and triglycerides. High-density lipoprotein showed significant increment. Small quantity of honey can be recommended for patients with dyslipidemia. The impact on clinical outcomes such as cardiovascular mortality and morbidity needs to be evaluated in large studies. PROSPERO REG. NO. CRD: 42020130741
Compartment syndrome is a surgical emergency that could be resolved by a fasciotomy. However, performing substantial skin incisions may lead to life-threatening complications. This narrative review aimed to present the available methods of wound closure and preferential factors for using each technique. Viable and noninfected wounds were most often treated by gradual approximation techniques, such as the simple or modified shoelace technique, the prepositioned intracutaneous suture or several commercially-available mechanical devices. In addition, applying negative pressure therapy was found to be feasible, particularly when combined with approximation techniques. Skin grafting was reserved for severely-dehiscent wounds while other non-invasive approaches were considered for other subsets of patients with inadvisable surgical interventions. Treatment decision should be made in view of the patient’s condition, ease of application, availability of resources, cost of treatment and aesthetic outcomes.Keywords: Compartment Syndrome; Fasciotomy; Wound Closure Techniques; Negative-Pressure Wound Therapy.
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