Colorectal cancer care in the COVID-19 era: outcomes from a 'mixed site' model.

INTRODUCTION: The COVID-19 pandemic has presented many challenges to colorectal cancer (CRC) care. Many organisations opted to perform CRC resections in 'cold' sites. Infrastructure in Northumbria Healthcare NHS Foundation Trust (NHCT) necessitated co-locating CRC care with 'hot' COVID streams but with additional precautions. This study aimed to evaluate that approach for a consecutive series of CRC cases, diagnosed before and during the COVID-19 pandemic. METHODS: A prospectively populated data set of CRC patients diagnosed between 1 April 2019 and 30 September 2020 was used. Patients presenting before 1 April 2020 were considered 'pre-COVID' and those presenting subsequently as 'COVID era'. RESULTS: Some 344 cases were diagnosed in the 12 months 'pre-COVID' and 166 in the 6 months of the 'COVID era'. The median numbers of days from referral to diagnosis (21 vs 20, p=0.373) and operation (63 vs 61, p=0.208) were unchanged. The 'COVID era' saw an increase in the proportion of radiological diagnoses (39.5% vs 53.0%, p=0.004) with an associated decrease in endoscopic diagnoses (56.7% vs 45.8%, p=0.021). Rates of inoperable (1.5% vs 1.2%, p=0.821), obstructing (11.0% vs 16.2%, p=0.272) and perforated tumours (0.6% vs 1.5%, p=0.492) remained the same. One patient developed COVID-19 perioperatively. Rates of laparoscopic operation (59.5% vs 61.8%, p=0.751), anastomotic leak (6.4% vs 5.9%, p=0.891), re-operative surgery (10.4% vs 4.4%, p=0.138), primary stoma (40.5% vs 32.4%, p=0.244) and 90-day mortality (0.6% vs 1.5%, p=0.492) did not change. CONCLUSIONS: With appropriate infection control measures, it may be safe to continue providing standard elective and urgent CRC care without access to a 'COVID clean' site.

Oxidative modifications of foetal LDL-c and HDL-c lipoproteins in preeclampsia.

BACKGROUND: Oxidative modifications have been observed in lipids and proteins in lipoproteins isolated from women with preeclampsia. Thus, newborns could also be susceptible to this damage directly through their mothers. In this study, we evaluated the oxidative profile of LDL-c and HDL-c lipoproteins isolated from the umbilical cord from newborns born to women with preeclampsia. METHODS: Thirty newborns born to women with preeclampsia and thirty newborns born to women with healthy pregnancies were included. Lipid-damage biomarkers, including conjugated dienes, lipohydroperoxides and malondialdehyde, were measured. The reduction of nitroblue tetrazolium, formation of dityrosines, and carbonylation of proteins were assessed as indicators of protein damage. The protective activity of paraoxonase-I on HDL-c particles was evaluated. The total antioxidant capacity and lipid profiles were quantified in plasma. Data were analysed using Student's t-tests and Pearson correlation coefficients. RESULTS: Compared with the control group, the preeclampsia group had an increase in the percentage of lipid damage in both lipoproteins. There was an increase of 23.3 and 19.9% for conjugated dienes, 82.4 and 21.1% for lipohydroperoxides, and 103.8 and 51.5% for malondialdehyde in LDL-c and HDL-c, respectively. However, these infants did not show evident damage in protein oxidation. The activity of the enzyme paraoxonase-I was decreased by 36.2%; by contrast, the total antioxidant capacity was increased by 40% (protein) and 28.8% (non-protein). CONCLUSIONS: The oxidative modifications that occur in HDL-c and LDL-c isolated from newborns from women with preeclampsia are mainly caused by lipoperoxidation processes related to evident paraoxonase-I inactivation. The absence of protein damage is likely linked to an increase in total antioxidant capacity. Therefore, antioxidant support could be helpful in reducing oxidative stress in mother/newborn dyads.

Consistency of hand use and sleep problems.

In this study, we measured the relationship between the consistency of hand use and three symptoms of insomnia, i.e., delayed sleep onset, frequent awakenings during sleep, and trouble returning to sleep after an awakening. For each of these insomnia-related symptoms, university students who were classified as inconsistent in the use of their hands (n = 30) were significantly more likely to report problems than their consistent hand-use peers (n = 30). These data were discussed both in relation to the literature on handedness classification and sleep problems and the emerging literature on consistency of hand use and health-related problems.

Ethnicity, Sleep Hygiene Knowledge, and Sleep Hygiene Practices.

We tested the mean differences in scores on Sleep Hygiene Knowledge and on Sleep Hygiene Practices among four ethnic groups of university students (N = 963). We computed significant main effects for ethnicity for both of these variables. Primarily the results reflect that the Euro-American students scored significantly higher on both scales than each of the other three groups.

Consistency of hand use and frequent falls.

We examined relationships between consistency of hand use and falling in groups of right-handed university undergraduates who were either consistent (n = 45) or inconsistent (n = 32) in the use of their hands. A scoring procedure developed for the Briggs-Nebes Handedness Scale permitted us to classify individuals as consistent or inconsistent in the use of their hands. The inconsistent group was 2.81 times more likely to have experienced frequent falls during the last 12-mo. period and was 1.64 times more likely to rate themselves higher on proneness to falling. These data suggest that inconsistent hand use may be a sign of a developmental inconsistency in motor coordination.

Boundaries and handedness.

The responses of 116 university students were used to assess a possible relation between scores on Hartmann's Boundary Questionnaire and the Briggs-Nebes Handedness Scale. Consistent with our prediction, the mean handedness score of the students with thin boundaries was significantly skewed in the direction of mixed-handedness.

Consistency of hand use, exercise, and sports-related injuries.

In this study, we examined the relationships between the consistency of hand use, exercise, and sports-related injuries as an indirect test of the hypothesis that the consistency of hand use is a reflection of general motor coordination. As we predicted, the consistent hand-use group (n = 23) exercised more, were more likely to follow a regular exercise schedule, and reported having experienced more sports-related accidents than their inconsistent hand-use peers (n = 23).

Ethnicity, sleep duration, and sleep satisfaction.

Analysis of responses of 1100 students from four ethnic groups to questions about the quantity and quality of their sleep indicated that ethnicity was modestly but significantly related.

Ethnicity and bruxism.

Distributions of students of four ethnic groups were statistically significantly different. 106 African-American students reported the lowest incidence of self-reported bruxism (9.4%), 452 Asian students the highest incidence (24.6%); 312 Euro-American and 225 Hispanic students' incidence was intermediate.

Boundaries and level of experience with six types of dreams.

The self-reported levels of experience to six types of dreams were compared for groups of students who classified as having either thin (n = 30) or thick (n = 86) boundaries. Consistent with predictions drawn from the literature, the thin-boundary group scored significantly higher on level of experience for each dream type than the thick-boundary group. These data provide additional validation for Hartmann's Boundary Questionnaire.

Fatal alcohol-related traffic crashes increase subsequent to changes to and from daylight savings time.

On the hypothesis that sleepiness and alcohol interact to increase the risk of alcohol-related traffic fatalities, the percentages of alcohol-related fatal traffic crashes were assessed for the entire state of New Mexico for the years 1989-1992, for each of the seven days that preceded the changes to and from Daylight Savings Time and for each of the 14 days which followed the changes to and from Daylight Savings Time. Consistent with our hypothesis the percentage of alcohol-related fatal crashes increased significantly during the first seven days after these changes in Daylight Savings Time.

Consistency of hand use and accidents with injury.

In this study, we examined the relationship between the consistency of hand use and the self-reported incidence of accidents with injuries which required medical care in groups of university students (n = 23 for each group). To do this, we adopted a scoring procedure for the Briggs-Nebes Handedness Scale that permitted us to classify individuals as consistent or inconsistent in the use of their hands. We observed that the inconsistent group was 6.12 times more likely to have experienced accidents with injury that required medical care than the consistent group. These data have implications for the literature on handedness classification and accidents. Collectively, these limited data underscore the need to pay attention to the consistency of hand use in research on handedness, health, and longevity.

Leisure and type A-B behavior.

Of 334 undergraduates, 152 scoring greater than or equal to 8 were classified as Type A and 182 scoring less than 8 as Type B. The groups did not differ in attitudes toward leisure activity, but Type A scorers claimed to spend significantly more time weekly in leisure activities than Type B scorers. This suggests Type A people live more intensely relative to type B scorers.