Health behaviors and well-being among those "living" with metastatic cancer in Alabama.

BACKGROUND: Approximately 5 million Americans are living with metastatic cancer. Metastatic cancer survivors (MCS) are at risk for poor health behaviors, which may negatively influence well-being. METHODS: Using a modified Dillman protocol, 542 MCS were mailed a survey querying physical and mental health (PROMIS® measures), health behaviors, and supportive care interest. Returned surveys were double-key entered into REDCap®. Data were analyzed using SPSS. RESULTS: Two hundred seventy-seven surveys were returned (51% response). Respondents (51% female; 88% Caucasian; 12% African-American; Mage = 65 years; Msurvivorship = 38 months; 23% female cancers, 23% melanoma, 21% gastrointestinal, 15% genitourinary, 12% pulmonary, and 6% other) reported low daily fruit and vegetable (F&V) intake (M = 4.1) and weekly minutes of moderate-to-vigorous physical activity (PA) (M = 41.9), with 66% of respondents having overweight or obesity. While mean scores for physical (M = 43.6) and mental (M = 47.7) health were considered "good," scores in the "fair" to "poor" ranges were observed (40% physical; 23% mental). MCS meeting PA (≥ 150 min per week) and dietary (≥ 5 daily servings of F&V) guidelines reported better physical (p = .003; p = .056) and mental (p = .033, p = .549) health, respectively, compared to MCS who were not. While current supportive care use was low (12%), future interest was high (57%), with greatest interest for nutrition (46%), MCS support group (38%), and gardening (31%). CONCLUSIONS: Our findings suggest that engaging in regular PA and consuming more F&Vs may enhance physical and mental health among MCS. Future research may explore supportive care approaches with high interest, such as gardening, to aid MCS in improving key health behaviors.

Usefulness of salivary sialic acid as a tumor marker in tobacco chewers with oral cancer.

AIM: This study aims to assess the usefulness of salivary sialic acid (SA) as a tumor marker in the detection of oral squamous cell carcinoma (OSCC) among tobacco chewers. MATERIALS AND METHODS: After the approval of study protocol by the Institutional Ethics Committee and informed voluntary consent, salivary samples were collected from 96 participants in each group of tobacco chewers with OSCC, tobacco chewers without precancerous or cancerous lesion, and healthy controls. Salivary protein-bound SA (PBSA) and salivary-free SA (FSA) were measured by Yao et al.'s method of acid ninhydrin reaction, and the data were subjected to appropriate statistical analysis. RESULTS: The salivary PBSA and FSA levels in the Groups 1, 2, and 3 participants were 31.17 ± 7.6 mg/dL and 63.45 ± 9.8 mg/dL, 25.45 ± 16.61 mg/dL and 33.18 ± 11.38 mg/dL, and 22.73 ± 3.01 mg/dL and 21.62 ± 8.86 mg/dL, respectively. Salivary FSA levels were significantly increased among the tobacco chewers with OSCC patients (Group 1) and tobacco chewers with no premalignant lesions of the oral cavity (Group 2) compared to the healthy controls (Group 3) with P < 0.05 being statistically significant. Salivary FSA levels were significantly increased in Group 1 as compared with Group 2. The salivary PBSA was high among Group 1 as compared to the control Group 3; there was however no significant difference in the levels of salivary PBSA between Group 1 and Group 2. There was no significant difference in the PBSA levels between OSCC patients of Group 1 and the tobacco chewers without precancerous or cancerous lesion in the oral cavity of Group 2. CONCLUSION: Salivary PBSA and FSA are significantly raised in both tobacco chewers with OSCC and in tobacco chewers with no precancerous or cancerous lesions in the oral cavity. SA should therefore be used cautiously while considering it as a marker for the early detection of oral cancer. Tobacco can be a crucial confounding factor when SA is used as a biomarker in OSCC since their levels are elevated to some extent even in tobacco chewers without any clinically obvious precancerous or cancerous lesions in the oral cavity.

Clinical spectrum, diagnostic criteria, and polymerase chain reaction of aqueous humor in viral and toxoplasma detection in Fuchs' uveitis syndrome.

AIM: The aim of this study is to describe the clinical features and diagnostic criteria of Fuchs' uveitis (FU) and to determine whether it has an association with virus and toxoplasma in the aqueous humor during cataract surgery. SETTING AND DESIGN: This is a prospective, case-control study. MATERIALS AND METHODS: Patients with FU (n = 25), anterior uveitis (n = 15), and no uveitis (normal) (n = 50) were included based on predefined inclusion and exclusion criteria for all three groups. Polymerase chain reaction (PCR) of aqueous humor and serum for rubella, herpes simplex virus (HSV), cytomegalovirus (CMV), varicella-zoster virus (VZV), and toxoplasma was done using conventional uniplex PCR. STATISTICAL ANALYSIS: It was done using SPSS software using Chi-square test for categorical variables, and P < 0.05 was considered statistically significant. RESULTS: Ninety patients were enrolled in the study in three groups, comparable for age, gender, and laterality of ocular involvement. All patients had diffuse keratic precipitates in FU group (P = 0001) with none having posterior synechiae (P = 0.046) which was statistically significant when compared to anterior uveitis patients. Iris nodules were noted in one case in both groups. Serum and aqueous PCR was negative for detection of VZV, CMV, toxoplasma, and rubella in all groups. PCR for HSV was positive in one patient in "normal" group but was not statistically significant. CONCLUSION: Our study shows that diagnosis of FU is mainly clinical. There appears to be no role of aqueous humor testing for viruses by PCR to aid in etiological diagnosis.

Effectiveness of interventions for the assessment and prevention of falls in adult psychiatric patients: A systematic review.

BACKGROUND: Patient fall is among the top five sentinel events in hospitals due to the resultant functional loss and injury sustained. Precise fall risk assessment and prevention strategies are important components of a fall prevention program. Due to psychiatric conditions and medications, these patients may require a different fall management program compared to other patient populations. OBJECTIVE: The objective of this review was to identify the best available evidence for the effectiveness of nursing fall risk assessment tools, interventions to reduce incidence of falls, and common risk factors of adult psychiatric patients who fall. INCLUSION CRITERIA: Adults (19 to 64 years) diagnosed with mental illnessEvaluation of nursing fall risk assessment tools in adult psychiatric settings, and interventions, which minimised fall risk or fall rates.Number of patient falls during hospitalisation was the main outcome.Primary quantitative studies published in English language. SEARCH STRATEGY: The literature search sought published studies, and was limited to English language reports. There were no date restrictions applied to the search. Electronic databases searched included:CINAHLPubMedCochrane Central Register of Controlled TrialsPsycINFOScienceDirectScopusWeb of ScienceWiley-InterScienceProQuestMedNar METHODOLOGICAL QUALITY: Studies retrieved were assessed by two independent reviewers for methodological validity prior to inclusion in the review using standardised critical appraisal instruments from the Joanna Briggs Institute System for the Unified Management, Assessment and Review of Information (JBI-SUMARI). DATA EXTRACTION: Data including specific details about the methods, settings, purposes, populations, interventions, and outcomes significant to the review's objectives were extracted by two independent reviewers using standardised data extraction tools from JBI-SUMARI. RESULTS: Eleven studies were included in this review: three before-and-after studies, four descriptive studies, two case control studies and two cohort studies. Evidence with regards to the effectiveness of fall risk assessment tools and prevention strategies was inconclusive. Certain risk factors which were more frequently associated with falls included diagnoses of depression, bipolar disorder, and dementia / Alzheimer's disease, altered mental status, physiological symptoms, past history of falls, mobility and gait problems, concurrent medical conditions, polypharmacy, and taking of certain medications such as sedatives, antidepressants and mood stabilisers, particularly lithium. CONCLUSION: Evidence on the effectiveness of fall risk assessment tools and prevention strategies in psychiatric setting was inconclusive due to a paucity of studies. However, certain risk factors were found to be more commonly associated with falls in adult psychiatric patients (Level III Evidence).Constant observation of the side effects of medications, particularly orthostatic hypotension, and review of patients' medical profile by doctors or pharmacists may be helpful in preventing falls in psychiatric patients. Findings on common risk factors can better aid healthcare professionals in identifying psychiatric patients who are at risk for falls.More research is needed on the evaluation of fall risk assessment tools and fall prevention strategies, specifically for the adult psychiatric patients. More prospective and better quality studies examining fall risk factors in psychiatric patients are needed.